Primary care physician pay up 16.5% since 2020, according to salary survey

Primary care physician pay is up 16.5% since 2020 – a “significantly larger” increase over other medical specialties, according to results of a new survey.

Workforce consultant SullivanCotter this month published its “2024 Physician Compensation and Productivity Survey Report,” and it appears doctors are taking home more for their work.

Total cash compensation (TCC) increased year-over-year across all major specialty categories. After significant increases in 2023, TCC has returned to historical average growth of 3.5%, according to the company.

Primary care has benefited from changes to the Medicare Physician Fee Schedule in 2021 and 2023, including the 2021 changes that boosted Medicare reimbursement for office-based evaluation and management Current Procedural Terminology (E&M CPT) codes, according to the SullivanCotter report.

The COVID-19 pandemic is having lingering effects on the compensation of doctors by changing expectations for the physician workforce, according to the company.

“The pandemic exacerbated workforce expectations for a more sustainable work life,” SullivanCotter Managing Principal Dave Hesselink said in a news release. “We see this manifested as reduced or eliminated call expectations, additional paid time off, fewer annual expected work hours, and more interest in compensation plans with a higher proportion of fixed compensation and a lower proportion of compensation at risk.”

Of pandemics and productivity

The 2024 survey documented decreases in annual expected work hours in critical care, hospital medicine, and radiology. Yet, TCC increased through productivity increases, with reported median work relative value unit (wRVU) productivity growing from 4% to 6% in adult medical care, primary care, and pediatric medical specialties, according to the report.

“This is likely due to ongoing recovery from the pandemic in 2023 as well as reported wRVU increases from the remaining organizations adopting the 2021 MPFS changes,” said Hesselink.

Increases to the wRVU values associated with hospital-based E&M CPT codes drove reported median wRVU increases in hospital-based specialties. That included 9.1% growth for hospitalist – family medicine physicians, 8.6% for emergency medicine, and 8.3% for hospitalist – internal medicine, according to the company.

Determining salary

Physician base salary and wRVU productivity continued to be the prevalent compensation plan components for primary care and medical and surgical specialties. Those accounted for 65% to 75% of pay in 2024, which was consistent for 2023, according to SullivanCotter.

As for value-based care, an estimated 50% of organizations used those payments, which made up 6.8% of TCC for specialists and 8.6% of salary in primary care.

“When it comes to compensation design, the days of a ‘one-size-fits-all’ approach for groups of any size or specialty mix are gone,” Mark Ryberg, SullivanCotter physician workforce practice leader, said in the news release.

“As the market looks to align compensation more closely with how care is delivered, we’re seeing varying approaches for physicians based on the care delivery model,” Ryberg said. “You’ll see significant differences, for instance, in the mix of compensation components and corresponding proportion of overall pay for a coverage-based specialist as opposed to a primary care physician, and even differentiation within primary care based on the patient population being served.”

The survey data came from more than 500 hospitals and health systems regarding approximately 215,000 doctors across 212 specialties. A 13% increase in physician records, SullivanCotter called it the largest and most comprehensive resource for health systems and hospitals.