Major Finding: Physicians practicing primary care medicine are paid at least $20 per hour less than their colleagues who practice surgery and specialty medicine.
Data Source: Reimbursement data from 6,381 physicians providing patient care in the 2004-2005 Community Tracking Study.
Disclosures: The study was supported by grants from the National Institute for Occupational Safety and Health and the University of California, Davis, Office of the Vice Chancellor for Research.
Primary care physicians receive the lowest reimbursement of all physician specialties, indicating a need for reforms that would increase incomes or reduce work hours for primary care physicians.
J. Paul Leigh, Ph.D., and his colleagues at the University of California, Davis, used data from 6,381 physicians providing patient care in the 2004-2005 Community Tracking Study.
Medical specialties were broken down into four broad categories: primary care; surgery; internal medicine subspecialists and pediatric subspecialists; and an “other” category with physicians practicing in areas such as radiation oncology, emergency medicine, ophthalmology, and dermatology.
Wages of procedure-oriented specialists were approximately 36%-48% higher than those of primary care physicians, the investigators found.
Specifically, specialties with statistically higher-than-average wages involve neurologic, orthopedic, or ophthalmologic surgery, use sophisticated technologies such as radiation oncology equipment, or administer expensive drugs such as oncology drugs in office settings, they found.
Lower-paid specialties were nonprocedural and relied on talking to and examining patients, they noted. “The major exception is critical-care internal medicine.”
Wages per hour for primary care physicians were about $61, while surgeons earned about $90 per hour and other procedure-oriented specialties earned close to $88 per hour, the study researchers said. Internal medicine subspecialists and pediatric subspecialists, meanwhile, earned slightly more than $82 per hour (Arch. Intern. Med. 2010;170:1728-34).
“The present findings suggest that legislators, health insurance administrators, medical group directors, health care plan managers and executives, residency directors, and health policy makers should consider taking action to increase incomes or reduce work hours for specialties near the bottom of the wage ranking list, particularly generalist specialties,” Dr. Leigh and his colleagues wrote.