Michael Rodriguez could’ve had it easy as an engineer enjoying a successful career. But he quit, entered medical school to become a surgeon, and ended up falling in love with family practice.

While not exactly rhapsodic about his new job in Virginia, Rodriguez says he made the right decision.

“I like this career,” he says, “but it’s a heck of a lot to go through. I’m working twice as hard as I was as an engineer. I work lots of hours, and I’m working at a much faster pace.”

He adds that his compensation “is at the bottom of the pile” compared with that of other specialists. “But if you are meant to blow glass in life, that’s your art; that’s your craft. What are you going to do?”

That seems to be the mindset of many primary-care docs, according to our first annual Merritt Hawkins/Physicians Practice Physician Compensation Survey. They’re not thrilled with their jobs, and they feel underpaid, but most are willing to stay in the game. They say it’s a calling more than a profession.



Some of the frustration Rodriguez and his colleagues currently feel can be chalked up to the vacillating demand for primary-care services. A decade ago, primary-care physicians held center stage as the nation’s healthcare “gatekeepers.” But in these days of PPOs and HSAs, the primary-care provider’s role is rather diminished. This may only be a short-term fall from grace. A graying population needs generalists who can manage multiple disease states, rising medical costs are a mounting national concern, and most signs indicate a shortage of primary-care physicians that experts say will only get worse before it gets better.

But for now, with low reimbursement rates and high overhead, today’s internists, family physicians, and pediatricians have little opportunity to enhance their income. They are the canaries in healthcare’s coal mines. Long before specialists are meaningfully affected by the pinch of low payments and regulatory burdens, primary-care physicians will be flat broke.



Physicians Practice figured it was time to check in with the nation’s primary-care practices to get the real scoop on the future of primary care as a whole, physician compensation levels, and individual career satisfaction. So we asked Merritt, Hawkins & Associates in Irving, Texas — one of the country’s largest physician recruitment companies — to examine these issues by gathering some facts. (view data on compensation for specialists)

Merritt Hawkins mailed surveys to 10,000 primary-care physicians selected at random from a national physician database. In the first quarter of 2006, 4,000 surveys were sent to family practitioners, 4,000 to general internal medicine practitioners, and 2,000 to pediatricians. The survey was sent out in February 2006, and 508 completed surveys were received in March 2006.

Forty-six percent of responses came from family practices, 28 percent from internal medicine practices, and 24 percent from pediatric practices.

All physicians selected for the survey have been in practice for at least two years — 89 percent of those who responded have been practicing for six years or more. The majority of those surveyed (roughly 68 percent) practice in groups of three or more physicians, while 10 percent practice in two-physician offices, and 29 percent maintain solo practices.



You call that a paycheck?