2008 Exclusive Survey-Earnings: Good news for primary care income

August 1, 2008

Primary care reimbursement rose substantially last year, but not all primary care specialties benefited.

Key Points

The 2008 Medical Economics Exclusive Survey is your chance to find out. Conducted in March and April, the survey asked more than 175,000 physicians about their compensation, productivity, practice size and setting, expenditures, and third-party payer arrangements, as well as basic demographic data. For more details on the survey methodology, go to http:// http://www.memag.com/2008survey.

The following pages feature an analysis of the results, broken down into three major categories: earnings, productivity, and malpractice premiums. Read on to discover what your colleagues earned last year - and how those earnings are affected by primary care specialty, practice type, physician age, years of experience, and other factors.

Primary care reimbursement rose substantially last year based on respondents' data, but not all primary care specialties benefited. While pediatricians enjoyed a 25 percent increase and family physicians' total compensation advanced 5 percent, the median incomes of GPs, internists, and ob/gyns dipped slightly compared to prior year statistics.

While Congress recently removed the specter of a 10.6 percent Medicare pay cut, the issue will have to be revisited in 18 months. Nevertheless, FP Robert L. Phillips Jr., director of the AAFP's Robert Graham Center for Policy Studies in Family Medicine and Primary Care, is cautiously optimistic about the future. "I think primary care doctors will see some earnings increases, even as other specialties may see declines," says Phillips, noting that the Medicare Payment Advisory Commission has proposed further pay hikes for primary care, and that business groups support the idea of payments for coordination of care.

Effects of demographics on income

Pediatrician Richard Lander of Livingston, NJ, who chairs the American Academy of Pediatrics' section on administration and practice management, notes that many pediatricians have not enjoyed the big jump in income that our survey reveals. The cost of giving childhood immunizations is higher than ever, he points out, and some practices continue to lose money on vaccines. On the other hand, some of his colleagues are boosting their income by requiring cash payments for shots, bypassing third-party payers. Pay for performance is also yielding "a dramatic increase in earnings" for some pediatric practices, Lander says.