SURVEY REPORT

Earnings: Time to call a code?

Income is stagnant or sliding for most primary care physicians, who typically earn less than they did in 1998.

By Mark Crane
Senior Editor

If physician income were represented on an ECG tracing, it might be time to call a code for primary care doctors. Despite working just as hard as ever, most of these physicians saw their practices' finances plateau or sink for the second consecutive year.

According to the Medical Economics Continuing Survey, which samples MDs and DOs in office-based private practice, median gross income in 2000 fell by 11 percent for general internists and GPs. It rose by 19 percent for ob/gyns and 12 percent for pediatricians, and was unchanged for FPs.

But the net income side of the ledger spells real trouble. GPs saw their median earnings decline by 16 percent. Pediatricians earned 2 percent less than in 1999. Median net income rose by a paltry 1 percent for FPs and ob/gyns, and was unchanged for general internists.

Those numbers didn't even keep pace with the overall 3.4 percent inflation rate of last year. Indeed, earnings performance since 1996 has been consistently mediocre for primary care fields. None came close to matching the 9.7 percent increase in the Consumer Price Index over that period; GPs earned 14 percent less than they did in 1996, and ob/gyns earned almost 7 percent less.

For the fourth year since 1995, FPs wound up with a median net higher than that of their general internal medicine colleagues. Ob/gyns are still the income leaders in primary care, with pediatricians in second place.

Some internal medicine subspecialists posted notable income gains last year. Invasive cardiologists had a 17 percent increase in median gross and an 8 percent boost in net. Noninvasive cardiologists saw their gross income decrease by 9 percent, while net earnings went up 3 percent. Gastroenterologists increased their median gross income by 9 percent; net earnings, however, struggled to rise just 1 percent. (This year, we also looked at seven other internal medicine sub-specialties.)

A change in statistical methodology prevents year-to-year comparison for data on all fields combined. (For a detailed description of how we conducted the Continuing Survey, see "How this year's survey was conducted".) Nevertheless, several trends emerge from a look at total figures for this year's respondents.

Surveyed physicians in groups of five to nine had the highest median gross and net incomes ($385,030 and $218,790, respectively). Doctors in single-specialty groups typically netted 23 percent more (or $39,190) than colleagues in multispecialty groups.

Physicians between the ages of 45 and 49 had the highest net earnings, as did doctors who have been in practice for 11 to 20 years. Not surprisingly, the youngest and most senior physicians earn considerably less than their middle-aged counterparts.

Midwestern physicians had the highest net incomes, typically earning $11,790 more than colleagues in the West, where earnings were lowest last year. Urban physicians netted $8,240 more than rural doctors, and $29,300 more than their inner-city colleagues.

The gender gap is still pretty wide. The typical female physician netted $42,100 less than her male counterpart. The gap in primary care earnings is narrowest among FPs, where male physicians earned about $20,000 more than female doctors.

Where do you stand in relation to your colleagues? The accompanying charts and tables will help you compare by specialty, age, geographic region, gender, and other variables. Watch upcoming issues for detailed reports on internal medicine subspecialties, fees and reimbursements, productivity, managed care's influence, and practice goals.

This article is copyright 2001 by Medical Economics at Montvale, NJ 07645. All rights reserved. It may not be reproduced, quoted, or paraphrased in whole or in part in any manner whatsoever without the prior written permission of the copyright owner.

How much did you earn last year?

The last five years: Income loses ground to inflation

How earnings varied in 2000

Midwestern physicians earn the most

Figures are medians for all respondents combined.

Inner-city doctors are struggling

The gender gap persists

A closer look at primary care net income

Where do you stand in the earnings race?

How this year's survey was conducted

Questionnaires for this year's Medical Economics Continuing Survey, developed and fielded under the direction of Sandy Johnson, manager of field services, were mailed in late March to 56,270 MDs and DOs in private, office-based practice throughout the US. This represents a random sampling of 16 selected specialties from the AMA master list maintained by Access Worldwide—the Phoenix Marketing Group. A follow-up mailing to nonrespondents took place in early May.

By the mid-June cutoff date, 7,124 MDs and DOs had responded. After we set aside returns with apparent discrepancies and those from physicians who hadn't been providing office-based patient care throughout 2000, our working sample consisted of 5,124 physicians. These were coded by the Medical Economics research staff and then tabulated by computer by Suzanne Coopersmith of Crosstabs Inc. of Syosset, NY.

The survey sample was selected to be representative within each specialty as to type of practice, age, geographical region, and gender. The results were weighted to reflect these criteria.

 

Mark Crane. Survey Report -- Earnings: Time to call a code?. Medical Economics 2001;18:74.