Does money buy happiness? The answer for doctors is not so clear.

In its annual survey of doctors, the website Medscape asked those in different specialties whether they would choose medicine again as a career if they had it to do over. Those most likely to say they would were among the lowest paid.  Among internists (average compensation $188,000), 68% were happy with their choice of profession, as were 67% of family practitioners ($176,000) and 63% of pediatricians ($181,000).

Those least likely to choose medicine again were among the highest paid. Only 41% of plastic surgeons ($321,000) would follow the same professional path. For orthopedists ($413,000), the percentage was 44%, and for radiologists ($340,000) it was 45%.

However, when asked if they would choose the same specialty again, the answers were different. Those most satisfied with their field included dermatologists ($308,000) at 77% followed by orthopedists at 64%, ophthalmologists ($291,000) at 61% and cardiologists ($351,000) at 61%.  Those least satisfied included internists at 27% and family practitioners at 32%.

One possible explanation for these numbers is that primary care physicians, such as internists, family practitioners and pediatricians, enjoy their role as doctors the most. But they find the burdens of practice in their fields, like lower pay and heavy administrative demands, especially troublesome.

If that is true, these numbers provide yet more support for policies to improve the lot of primary care practitioners relative to specialists. As access to care expands under the Affordable Care Act, their role will only grow in importance.