Physician income is stuck in neutral.
According to this year's Physicians Practice Physician Compensation Survey, only 31.8 percent of physicians saw their salaries go up from 2015. In last year's survey, this number was 31.7 percent. Moreover, nearly 40 percent of respondents say their personal income was about the same from last year, which was essentially identical to last year's survey as well.
What about the difference between specialists and primary-care physicians? There is evidence suggesting that the gap in pay between primary-care physicians and specialty physicians is decreasing. Last year, 52.5 percent of family physicians made between $175,001 and $250,000 in income; this year that's gone down to 45.8 percent. Meanwhile, the number of family physicians making $250,001 to $350,000 has gone up from 5 percent to 26.39 percent over the past year.
"Primary-care [salaries] have gone up. The demand is there, it has and will continue to grow. From our data … family practice is the number one searched [physician specialty for potential jobs], which correlates to a higher demand," says Kurt Mosely, vice president of strategic alliances for Irvine, Calif.-based physician recruiting firm, Merritt Hawkins, who says demand has increased the overall pay of these family physicians.
Yet, Mosely is quick to add, "There is still that gap."
Is Primary Care Underpaid?
Indeed, while family-medicine physicians say they are bringing in more money than in the past few years, medical specialists are still in the upper echelon of income when compared to other physicians. For instance, of the surgical specialists who answered the compensation survey, nearly 40 percent said they make more than $450,001 per year — which was by far the highest salary tier for any specialty. Only 2.3 percent of responding family-medicine physicians made that much.
Will Latham, a Chattanooga, Tenn.-based consultant who advises practices on compensation structure, says that primary-care physicians saw small increases in pay during the 1990s and the early days of Medicare's resource-based relative value scale (RBRVS). However, he says, over time those financial gains slowed down for primary-care physicians, while specialists, with a major leg up from their advocacy groups that petitioned Congress for better Medicare reimbursement, continued to see increased compensation.
He adds that medical specialties benefit from "big-ticket items," such as MRIs or CT scans, which can be additional avenues of income, whereas primary-care physicians don't really have that. "Most family physicians realize they have to see a [certain] volume of patients to generate income, five to 10 minutes is what they are shooting for. It's a short period of time," Latham says.
William Creevy, a Boston-based orthopaedic surgeon as well as the vice chair of the American Association of Orthopedic Surgeons' (AAOS) Coding, Coverage, and Reimbursement Committee, says that primary-care physicians also do a lot of work that doesn't get reimbursed. "If the patient calls and you spend 15 minutes on the phone explaining and answering their questions, although there are CPT codes that describe doing work over telephone, hardly any insurance companies recognize that. There is a lot of work coordinating care, doing these phone calls, reviewing things, it's extra work but there is no reimbursement for it. Good primary-care physicians do this every day," he says.