Managed Care

Primary care pay falls again











Primary care physicians' compensation continues to decline, according to the American Medical Group Association's 2003 Medical Group Compensation and Productivity survey. Over the past year, internists, pediatricians and adolescent medicine physicians, pulmonologists, emergency care physicians, ophthalmologists, and pathologists got the short end of the compensation stick.

"This is not a trend that is going away," says Donald W. Fisher, PhD, president and CEO of AMGA. "With the decline in use of the gatekeeper model, there is not as much demand for the primary care physician." Market demand and new technology affect physician compensation. Fisher also cites lower physician reimbursement rates from Medicare and Medicaid. "Since these ... rates are generally used as the benchmark for commercial insurers' rates, many physician groups are struggling with lower revenue from both their public and private payers," says Fisher.

Not all specialists experienced a compensation decline, however. The survey found that gastroenterologists, otolaryngologists, and radiologists experienced large increases in compensation. Significant increases were also seen in cardiology, hematology, medical oncology, and orthopedic surgery.

Median physician compensation 2001–2002

SOURCE: 2003 MEDICAL GROUP COMPENSATION AND PRODUCTIVITY SURVEY, AMERICAN MEDICAL GROUP ASSOCIATION.

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