American humorist Evan Esar (1899-1995) once called statistics "the only science that enables different experts using the same figures to draw different conclusions."
There may have been more than a touch of wisdom in Esar's comment given the AAFP's ongoing efforts to ensure that family physicians are not financially harmed by the misuse of data by some employers when creating physician compensation packages.
After months of research, discussion and collaboration, the AAFP and the Medical Group Management Association (MGMA) recently released a joint statement(1 page PDF) to provide guidance on how the annual MGMA Physician Compensation and Production Survey data should be used.
According to the statement, MGMA survey data have been used "for more than 35 years as a benchmark for compensation and production" in practices of various sizes and types across the country.
"Our organizations (AAFP and MGMA) collect data on our respective members on a regular basis and make that data available in various formats to our members and the public. In doing so, we clearly state that the information presented is for the purpose of informing members and nonmembers alike," says the statement. "The information … is not intended to be used for the purpose of limiting competition, restraining trade, or reducing or stabilizing salary or benefit levels."
- The AAFP has received reports from family physicians that their employers were misusing survey data to set higher compensation rates for general internal medicine physicians than for family physicians.
- In response, the AAFP and the Medical Group Management Association (MGMA) collaborated to create a statement to clarify how physician employers should appropriately use data from the MGMA's annual Physician Compensation and Production Survey.
- The AAFP also created a template letter for physicians to use as a supporting document when discussing compensation with their employers.
"Unfortunately, some AAFP members have expressed concern over potential misuse of (MGMA) data," the statement says.
Todd Evenson is VP of MGMA's Data Solutions and Consulting Services. He told AAFP News that MGMA reports typically include data from more than 60,100 providers in 170 specialties including more than 7,500 family physicians, and represent the largest sample of physician compensation data available in the United States.
For decades, "MGMA surveys have been recognized as the definitive source of compensation and productivity data by providers and organizations alike," said Evenson. MGMA also provides programming to educate users on best practices in structuring compensation plans.
Evenson emphasized that MGMA data is intended to be descriptive rather than prescriptive.
Kent Moore, the AAFP's senior strategist for physician payment, told AAFP News that early on in his work with MGMA on the issue, he learned that one particular piece of MGMA survey information -- the compensation per relative value unit (RVU) data -- was often misused and misinterpreted. In the MGMA data, compensation per RVU is typically higher for general internal medicine than for family medicine, leading some employers of family physicians to conclude that general internists should be paid more than family physicians.
Multiple reasons could be found for why general internal medicine compensation per RVU might be higher than corresponding data for family medicine, said Moore.
- Many private payers use multiple conversion factors that vary, for example, by types of service. General internists may earn more if they offer patients a basket of services that is different from that of their family physician colleagues.
- The payer mix also is a factor in figuring total compensation. For example, if family physicians include more Medicaid patients in their patient panels, their compensation may be lower even if the services they provide are the same as those provided by their general internist colleagues.
- Some medical groups are more successful than others at negotiating higher compensation rates from private payers, and general internists could disproportionately be a part of those higher-paid groups.
Similar bullet points were included in a template letter(2 page DOCX) now available for family physicians to use as a supporting document if they suspect that their employers are misusing MGMA survey data in contract and salary negotiations.
Both the statement and the letter were the direct result of a resolution titled "Equity for Family Medicine Relative Value Unit (RVU) Compensation" that the Florida AFP introduced during the 2013 AAFP Congress of Delegates.
That resolution -- referred to the AAFP Board of Directors and then to the AAFP's Commission on Quality and Practice -- specifically asked the AAFP to develop appropriate resources for AAFP members to assist in their negotiations with employers.
Related AAFP News Coverage
2013 Congress of Delegates
Misuse of Salary Data, Coding Top List of Practice Enhancement Concerns
More From AAFP
Family Practice Management's Getting Paid blog: Lies, damned lies, and statistics
(March 1, 2013)