WA public hospital doctors are among the best paid in the country, earning about $50,000 on average a year more than their Eastern States peers, according to WA's health boss.
Director-general of health Kim Snowball conceded this week WA was paying a premium for its doctors to keep them here.
Wage increases which kicked in late last year and this month mean a senior consultant can earn more than $350,000 a year before any overtime or on-call bonuses.
Mr Snowball said 1950 hospital doctors received an allowance of up to $94,304 a year - known as Arrangement A - on top of their base salary.
Under the agreement, doctors get an annual payment by forgoing income from private patients they admit, including doctors who never admit private patients, such as emergency physicians, and medical administrators who never treat patients.
First-year consultants earning $159,571 a year can get the extra $94,304, plus a professional development allowance of $24,524, giving them a total base wage of $278,399.
Senior consultants getting both payments can earn $354,588 a year.
Mr Snowball defended Arrangement A, saying it was not directly linked to how much private revenue doctors could earn for hospitals but had become a way to top-up up salaries to match those in other States.
Seven per cent of patients in public hospitals were admitted as private cases and the annual revenue was $84 million, below the cost of Arrangement A, but he said they were never intended to match up.
He said the pay of WA doctors had been falling behind those in other States, leading to a drain to Queens-land, but a recent national comparison found they earned about $50,000 more than the Australian average.
"Right at the moment we're above the average in terms of what the market is paying," he said.
"There was a lot of pressure when our doctors slipped below a competitive rate in remuneration compared to other States, but more recently the assessment is that we're above the national average."
Australian Medical Association WA president Richard Choong questioned the disparity between wages and said if it was so big doctors would be "racing here from other States".
"We acknowledge that salaries in WA were behind most other States and much of that lost ground has been made up in recent years," he said.