Primary care physician pay up 2.13% in 2021, still lower than specialists

Primary care physician total compensation rose 2.13% from 2020 to 2021, but the percentage increase was lower than those for surgical and nonsurgical specialists.

Meanwhile, compensation for most physician specialties in 2021 reached or exceeded levels frm before the COVID-19 pandemic, “outstripping the mostly flat results achieved in a lockdown-heavy 2020,” according to the Medical Group Management Association (MGMA).

The association published “Provider Pay and the Pandemic: Realizing Recovery,” its report on findings in its 33rd annual MGMA DataDive Provider Compensation. The analysis includes data from more than 192,000 health care providers across more than 7,700 organizations.

“As we continue to emerge from the pandemic, I’m pleased to announce that data trends are more than stable, despite the countless challenges the industry has experienced over the past two years,” MGMA President Halee Fischer-Wright, MD, MMM, FAAP, FACMPE, said in a press release. "Providing a more holistic view of the industry, the insightful and actionable data in this report is invaluable for healthcare practices — both today and for ongoing future planning.”

Median total compensation for primary care physicians was $286,525 for 2021, up 2.13% from the year before. But the percentage increase was lower than the 3.89% increase for surgical specialists, whose median total compensation was $517,501, and lower than the 3.12% increase nonsurgical specialists, whose median total compensation topped $400,000 in 2021.

Compensation increases from 2019 to 2021 included:

• Family medicine without obstetrics: 5.6%
• Internal medicine – hospitalists: 2.55%
• Internal medicine – general: 4.57%
• Obstetrics/gynecology – general: 3.63%
• Pediatrics – general: 1.77%

Primary care physicians coming out of residency and newly hired to practices in 2021 reported earning 7% to 10% more in guaranteed compensation than their counterparts who were hired in 2020, the report said.

As for patient encounters, 15% of medical practices reported volumes declined in summer 2021 due to the Delta variant spike, while 42% said patient volumes increased and 43% reported volumes stayed the same.

2022 forecast

For 2022 so far, “medical groups are signaling some optimism, with 85% reporting their year-to-date visit volumes are at or above 2021 levels,” the report said.

This year’s productivity levels will depend on several issues, according to MGMA:

• Ensuring appropriate staffing levels to handle greater volumes
• Filling appointment slots previously used for COVID-19 testing and vaccinations as vaccine demand drops and patients use home test kits
• Engaging patients who don’t visit due to growing financial concerns about high-deductible health plans, consumer costs and inflation

Physician trends

The MGMA report noted two issues that have received national attention in recent months: physician burnout at critical levels and doctors moving away from physician-owned practices.

In October 2021, an MGMA poll found one in three medical practices had physicians retire early or leave due to burnout in the last year. That stress “likely won’t subside just because the pandemic eases,” the report said.

Electronic health record fatigue, fighting with insurance companies over prior authorizations and staff shortages likely will continue without being addressed, the report said.

MGMA cited the American Medical Association 2020 report that noted for the first time, less than half of patient-care physicians (49.1%) reported working in a physician-owned practice. That was down almost 5% from 2018 and down 11% since 2012.