Family Physician Salaries Up but Still Trail Those of Subspecialists

May 13, 2015 01:49 pm Michael Laff

Family physicians are earning more than they did last year, with salaries that are growing faster than those for most other specialists, according to an annual survey on physician compensation. Still, the income gap between FPs and other specialists remains wide.

[Doctor talking to elderly female patient in office]

On average, primary care physicians overall -- and family physicians, specifically -- earn $195,000 annually, compared with $284,000 for physicians in other specialties, the 2015 Medscape Physician Compensation Report( found. Pediatricians were the only specialty with a lower average salary, at $189,000 per year. However, salaries for family physicians rose 10 percent between 2014 and 2015, the fifth highest rate of increase for any specialty.

Nearly 20,000 physicians participated in the survey, which was conducted from Dec. 30, 2014, to March 11 of this year. Of them, family physicians and internists made up the highest volume of respondents, with each specialty comprising 12 percent of total respondents.

Need for Value-based Compensation

"The survey demonstrates that the importance of family medicine continues to be undervalued by the health care system," said AAFP President Robert Wergin, M.D., of Milford, Neb. "There is hope that with passage of the MACRA (Medicare Access and CHIP [Children's Health Insurance Program] Reauthorization Act) legislation, there will be a movement away from the volume-based, fee-for-service world that is focused on acute illness and episodic care to a payment system that is value-based, and this will improve the compensation and value of family physicians."

Story highlights
  • Primary care physicians earn $195,000 annually, on average, compared with $284,000 for other specialists.
  • Salaries for family physicians rose 10 percent between 2014 and 2015, the fifth highest rate of increase for any specialty.
  • Family medicine ranks sixth overall among specialties that employ the highest percentage of female physicians, at 35 percent.

As it stands, 47 percent of primary care physicians think they are fairly compensated, compared with 50 percent of other specialists.

Worth noting is the fact that a physician's practice situation exerts a significant influence on annual compensation. Primary care physicians who are employed earn an average of $189,000 annually compared with $212,000 for self-employed physicians.

In addition, family medicine ranks sixth among specialties in employing the highest percentage of female physicians, at 35 percent. Unfortunately, however, the gender-based income gap in medicine continues, with male physicians across all specialties earning, on average, $55,500 more than female physicians.

"There is a disparity in our profession, and as an Academy, we have to keep advocating for equal pay for equal work," Wergin said. "We're behind, and not just in family medicine."

Focus on Other Practice Issues

The survey covered much more than salary issues, focusing as well on hours spent with patients and overall career satisfaction. Several questions focused specifically on primary care, including family medicine.

For example, 34 percent of family physicians said they spend between 13 and 16 minutes with each patient, another 23 percent reported they spend 17 to 20 minutes per patient, and 22 percent said they spend 9 to 12 minutes with each patient. And primary care physicians overall devote considerable time to paperwork and administration, with 33 percent of self-employed and 27 percent of employed primary care physicians reporting that it takes 10 to 14 hours per week.

Regarding career satisfaction, family physicians ranked highest in terms of saying they would choose a career in medicine again, with 73 percent reporting that they would. But only 32 percent of FPs said they would choose the same specialty.

AAFP President-elect Wanda Filer, M.D., M.B.A., of York, Pa., said that although she was "thrilled" to see that family physicians were the specialists most likely to say they would choose medicine again, she was concerned that so few of them would again choose family medicine as their specialty. She chalked it up to the stress of navigating an increasingly complex practice environment.

"I know that burnout is a huge issue, brought on, at least in part, by ridiculous administrative burdens that take us away from rewarding face-to-face time with patients -- the real reason we went into medicine," Filer said.

Filer is encouraged to see residents and students "who are ready to change the world," but cautioned that more needs to be done to ensure that FPs who have been in practice for a while retain that same enthusiasm.

"It is important to help all of our members rediscover and sustain the joy of practice," she said. "We work daily to mitigate those many burnout factors coming from the practice front."

According to the survey report, family physicians ranked eighth overall in terms of offering new ancillary services -- such as MRI, physical therapy, orthotics or in-office surgery -- in their practice in the past three years, with 23 percent saying they have offered a new service during that period.

The report also noted that overall physician participation in accountable care organizations (ACOs) continues to grow at a rapid rate, with the percentage increasing from just 3 percent in 2011 to 30 percent in the 2015 survey report. Among primary care physicians, 35 percent said they participated in an ACO.

Wergin remains optimistic that policy changes at the federal level and a shift toward a greater emphasis on primary care worldwide are promising trends.

"Our value is going to increase as it is already recognized in every other developed country in the world," he said. "Countries such as Canada and England realized you cannot build a health care delivery system without a strong primary care base, and they reimburse their primary care physicians in line with that value.

"We're behind those systems now, but we're moving in their direction."