Primary care physicians worked harder and were rewarded, if not commensurately

Doctors in fee-for-service primary care saw their salaries increase more from 1997 to 1998 than their subspecialist and surgical peers, but they worked hard for it. Ernst & Young’s annual Physicians Benchmarking Survey of salaried physicians in group practices and integrated delivery systems reports that “Compensation for primary care … is advancing faster under fee-for-service reimbursement than under managed care, a reversal of a four-year trend.” Total compensation in primary care rose 7.0 percent, while surgical specialties’ compensation went up 4.0 percent and those in medical and procedural specialties actually saw their income decline. Primary care doctors traded higher production for their raises: Average gross charges per physician rose 16 percent during the period. Primary care doctors in primarily fee-for-service situations averaged 8.0 percent pay increases; those in managed care settings, none at all (yielding the 7.0 percent average increase for all groups surveyed).

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