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Payment Disparity: Primary-Care Providers Earn Less, Often Work More


With its perceived less-demanding work schedule, primary care is typically viewed as one of the more family-friendly careers for physicians. But a new report shows this perception may be inaccurate.

With its perceived less-demanding work schedule, primary care is typically viewed as one of the more family-friendly careers for physicians. But a new report shows this perception may be inaccurate.

The study, published in the Archives of Internal Medicine, sheds light on compensation disparities in the physician field. It finds that though primary-care physicians earn less than specialists, they work the same amount of hours - or more in some cases.

As the shortage of primary-care providers increases, the report provides one more reason medical students may decide not to pursue the primary-care route.

The study’s author, public health sciences professor at the University of California, Davis J. Paul Leigh, told Healthcare Finance News the results emphasize the need for compensation changes.

“Let’s make some adjustments here and try to be more reasonable about reimbursements in light of what their income is and also, of course, in light of what the hours are, because physicians are going to be concerned not just with the pay but with the hours of work,” he said.

Leigh’s findings regarding work hours and earnings justify concerns physicians voiced to us in our 2010 Great American Physician Survey and our 2010Physician Compensation Survey.

A whopping sixty-seven percent of our Great American Physician survey responders told us you don’t have as much time for your personal life as you think you should. Nearly half of you said you wish you worked fewer hours per week. And 13 percent of you said you “hardly ever” eat with your spouse or your minor children.

At the same time, the majority of you (65 percent of solo providers, 43 percent of providers in groups of two to nine, 64 percent in groups of 10 to 20, and 40 percent in groups of more than 20) told us in our Physician Compensation Survey that your compensation was disappointing.

Though specialists took part in both of our surveys, nearly half of responders to our Great American Physician Survey, and more than half of responders to our Physician Compensation were primary-care providers.

Leigh and his colleagues reached their research results by analyzing a sample of 6,381 physicians from the 2004 to 2005 Community Tracking Survey (CTS). The CTS, sponsored by the Robert Wood Johnson Foundation, is a nationwide investigation of changes in the American healthcare system and their effects on people. Leigh’s sample from the CTS included 41 specialties (including primary care, surgery, internal medicine, and pediatrics).

The primary-care physicians worked hours in the middle range of the sampled physicians, according to the researchers. Yet, the researchers also found that these physicians earned lower wages than the others in the sample.

More telling, some physicians - like dermatologists- worked less but earned more than the primary-care providers.

“I kind of anticipated that their annual work hours were going to be very low, but they weren’t,” Leigh said. “They were in the middle of the group … I thought that they would be toward the low end.”

According to Leigh’s study, on average physicians (all of those included in the sample) worked 48.5 hours per week.

Primary-care providers, is your life reflected in the results from Leigh’s study? And what do you think of the payment disparity between you and specialists? 

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