Graham Center One-Pager

The U.S. Primary Care Physician Workforce: Undervalued Service

Primary care physicians work hard, but their compensation is not correlated to their work effort when compared with physicians in other specialties. This disparity contributes to student disinterest in primary care specialties.

From 1980 to 1999, family physicians, general internists, and general pediatricians have been outnumbered by specialists. Despite this disparity, these primary care physicians have continued to provide a larger proportion of office-based visits than specialists; while comprising a minority of physicians, primary care physicians provided a majority of visits made to doctors' offices.

Specialist Average number of patient visits per week, 1999 Net income after expenses, before taxes, 2000 Family physician 122.9 $144,700 General pediatrician 120.5 $137,800 General internist 106.5 $164,100 Gastroenterologist 89.9 $299,200 Cardiologist 92.4 $315,500 Orthopedic surgeon 114.3 $335,800 SOURCE: AMA Physician Socioeconomic Statistics, 2003 Edition, p. 186, 188, and 193.

The disproportionately large service commitment by primary care physicians has not been rewarded compared with other types of physicians.

See editorial on page 1494.

Continuing to pay primary care physicians considerably less than other doctors discourages medical students from choosing primary care careers. This disparity threatens access to care and impedes achieving better health for all Americans. A better balance of physician reimbursement for care is urgently needed.

NOTE: The information and opinions contained in research from the Graham Center do not necessarily reflect the views or the policy of the AAFP.

Number of Office Visits Compared with Number of Office-Based Physicians from 1980-1999 SOURCE: The National Ambulatory Care Surveys 1980-1999.

Adapted from Graham Center One-Pager #24. Biola H, Green LA, Phillips RL, Guirguis-Blake J, Fryer GE. The U.S. primary care physician workforce: undervalued service. October 2003. Available at: www.graham-center.org/x469.xml. From the Robert Graham Center: Policy Studies in Family Practice and Primary Care, 1350 Connecticut Ave., NW, Suite 950, Washington, DC 20036 (telephone: 202-986-5708; fax: 202-986-7034; e-mail: policy@aafp.org).