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Am Fam Physician. 2003;68(8):1486

See editorial on page 1494.

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.

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

SpecialistAverage number of patient visits per week, 1999Net income after expenses, before taxes, 2000
Family physician122.9$144,700
General pediatrician120.5$137,800
General internist106.5$164,100
Orthopedic surgeon114.3$335,800

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.

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

This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

A collection of Graham Center Policy One-Pagers published in AFP is available at One-Pagers are also available at

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