Primary Care Income at the Bottom

Survey after survey has shown that primary care doctors are at the low end of the pecking order when it comes to compensation. The latest is from Merritt Hawkins, a Texas-based physician recruitment firm, which reviewed more than 3,200 recruitment assignments it conducted in the 12-month period ending on March 31. The study shows that the average salary offered to family physicians is the lowest of any specialty.

The low salaries seem to counter the economic theory of supply and demand, according to the study. Requests for family doctors outpaced assignments for any other specialist, and the number of searches for family physicians has grown by 23% over the previous 12-month period. In spite of the surge in demand and the relative scarcity of family doctors, the average annual salary offered to them was $173,000, far short of the average salary of $419,000 that cardiologists got, or the $481,000 given to orthopedists. Another Merritt Hawkins study shows that the gap is widening—salaries paid to primary care doctors grew by just 7.4% between 2005 and 2008, whereas salaries for specialists went up by 25% in the same period.

According to many healthcare experts, the lopsided salary structure is a major cause of the dire shortage of primary care doctors, which critics point out could get even worse if a healthcare reform package that includes universal health insurance becomes law. The Obama administration has floated ideas like loan forgiveness for medical students who choose primary care but hasn’t indicated that it would boost Medicare payments to primary care doctors. Because the Medicare reimbursement pie is finite, giving primary care doctors a bigger slice would mean a smaller piece for specialists.