Clinical Infectious Diseases 352 • CID 2019:69 (15 July) • VIEWPOINTS Infectious Diseases Physicians: Improving and Protecting the Public’s Health: Why Equitable Compensation Is Critical Matthew Zahn, 1 Amesh A. Adalja, 2 Paul G. Auwaerter, 3 Paul J. Edelson, 4 Gail R. Hansen, 5 Noreen A. Hynes, 6 Amanda Jezek, 7 Rodger D. MacArthur, 8 Yukari C. Manabe, 9 Colin McGoodwin, 7 and Jeffrey S. Duchin 10 1 Epidemiology and Assessment, Orange County Health Care Agency, California; 2 Johns Hopkins Center for Health Security, Johns Hopkins University, and 3 Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, Johns Hopkins University School of Medicine, Baltimore, Maryland; 4 Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York, New York; 5 Hansen Consulting LLC., Washington, D.C.; 6 Schools of Medicine and Public Health, Johns Hopkins University, Baltimore, Maryland; 7 Public Policy and Government Relations, Infectious Diseases Society of America, Arlington, Virginia; 8 Offce of Academic Affairs, Medical College of Georgia at Augusta University; 9 Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland; and 10 Communicable Disease Epidemiology & Immunization Section, Division of Infectious Diseases, Seattle and King County Public Health Department and University of Washington School of Public Health Infectious diseases (ID) physicians play a crucial role in public health in a variety of settings. Unfortunately, much of this work is undercompensated despite the proven efcacy of public health interventions such as hospital acquired infection prevention, antimi- crobial stewardship, disease surveillance, and outbreak response. Te lack of compensation makes it difcult to attract the best and the brightest to the feld of ID, threatening the future of the ID workforce. Here, we examine compensation data for ID physicians compared to their value in population and public health settings and suggest policy recommendations to address the pay disparities that exist between cognitive and procedural specialties that prevent more medical students and residents from entering the feld. All ID physicians should take an active role in promoting the value of the subspecialty to policymakers and infuencers as well as trainees. Keywords. public health; ID physician workforce; compensation; value of ID physicians. In recent decades, emerging and reemerging infectious dis- eases (ID) have caused outbreaks with national and interna- tional implications and have underscored the critical need for ID expertise. ID physicians do more than protect the health of their patients. Due to the unique communicable nature of ID, ID physicians provide a population-level service by helping to secure the health of the community. However, as ID threats to public health continue to emerge, the number of young physi- cians applying for ID subspecialty training continues to wane. ID physicians lead public health responses in their health- care facilities and communities and at federal and global levels. In the last 2 decades, ID specialists have played vital roles in responding to emerging diseases and epidemics including West Nile virus (1999), severe acute respiratory syndrome (SARS; 2003), H1N1 pandemic infuenza (2009), Middle East respira- tory syndrome (MERS; 2012 and ongoing), Ebola virus (2014– 2016 and ongoing), and Zika virus (2016 and ongoing). While these outbreaks garner a great deal of media visibility, ID phy- sicians also routinely detect, prevent, or mitigate community outbreaks of vaccine-preventable diseases, foodborne illness, and healthcare-associated infections. The work performed by ID doctors in the United States is substantially undercompensated. ID physician salaries av- erage around $100 000 a year less than other subspecialties [1, 2]. Young physicians, who generally complete training with substantial educational debt, can be driven from con- sidering the field [1]. Developing a robust ID workforce of the future requires a strategy to attract quality physicians and keep them engaged on the frontline of patient care, re- search, and public health. Despite their documented value, ID physicians’ services are undervalued by payers compared to primary care and procedure-based specialties. A gradu- ating trainee finishing an internal medicine residency can work immediately as a hospitalist at a higher mean salary than an ID physician who will take 2 to 4 additional years of fellowship training. Such variances in compensation for di- rect patient care and insufficient pay for value in other roles such as infection control creates a significant disincentive to pursuing a career in ID. Te 2017 Medscape Physician Compensation Report reveals that the median salary of a specialty physician to be approxi- mately $316 000 per year [1]. Te Infectious Diseases Society of America’s (IDSA) 2017 compensation survey showed that the average ID physician earns about $215 000 a year. Full-time public health physicians averaged $30 000 per year less [2]. VIEWPOINTS © The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. DOI: 10.1093/cid/ciy888 Received 28 February 2018; editorial decision 26 September 2018; accepted 15 October 2018; published online October 17, 2018. Correspondence: C. McGoodwin, 1300 Wilson Boulevard, Suite 300, Arlington, VA 22314 (cmcgoodwin@idsociety.org). Clinical Infectious Diseases ® 2019;69(2):352–6