Pay for Family Physicians Up a Notch

Marcia Frellick

April 18, 2018

Pay for family medicine physicians was up 5% in this year's Medscape Compensation report compared with an increase of only 1% last year, although they continue to rank near the bottom in annual compensation.

This year, with pay at $219,000, they ranked higher than physicians in pediatrics ($212,000), diabetes and endocrinology ($212,000), and public health and preventive medicine ($199,000). Last year they ranked above only pediatricians. The report authors note that the lowest-earning specialties were also the lowest 5 years ago.

In contrast, plastic surgeons were the highest-paid this year, with compensation of $501,000. They also had the second-highest jump in pay, at 14%, second only to psychiatry, at 16%.

Pay Is Only Part of the Package

Pay, however, does not always correspond with pay satisfaction. For instance, although they are the highest paid, only 50% of plastic surgeons said they were fairly compensated, whereas public health physicians ranked third from the top, at 69% in pay satisfaction.

Family physicians fall in the middle of specialties in pay satisfaction: 61% said they were fairly compensated, up from 53% last year. Among those not satisfied with pay in family medicine, 44% said they should make 11% to 25% more. Emergency medicine had the highest pay satisfaction (74%); physical medicine and rehabilitation was the lowest, at 46%.

In addition, "making good money at a job I like" was listed by only 11% of family physicians as what was the most rewarding part of the job. The top two answers were gratitude from patients/relationships with patients (30%) and making the world a better place (27%).

Most See Patients 30-45 Hours a Week

Most family physicians (66%) report spending 30-45 hours a week seeing patients. Ten percent reported spending fewer than 30 hours seeing patients, and 3% reported more than 65 hours.

Most (71%) reported personally spending between 13 and 24 minutes with each patient.

Paperwork continues to be a large burden and a prime source of burnout for physicians. This year, 77% of family physicians reported spending more than 10 hours a week on administrative tasks, up from 62% last year.

Almost a third (32%) of family physicians surveyed said "having so many rules and regulations" was the most challenging part of the job.

Gender Gaps Remain

Gender gaps in family physician pay remain, with male physicians averaging $234,000 vs $198,000 among female physicians.

As in past years, female family physicians were more likely to work part time than their male counterparts (25% vs 14%); however, the salary comparisons in the report only include full-time salaries, the report authors note.

Most family physicians are employed (78% vs 19% self-employed), which fits with a national trend as hospital mergers and acquisitions have bought up private practices. More women family physicians are employed than their male peers (83% vs 74%), which may help account for the pay differences, report authors say.

Among black and mixed-race family physicians, women strongly outnumbered men, (86% vs 14% and 70% vs 30%, respectively), but among Asian, Hispanic, and white family medicine physicians, men outnumbered women.

Payment models have changed, and many physicians report they would like to see the Merit-Based Incentive Program changed or abolished. Among family physicians, 34% participate in the program. In comparison, gastroenterology had the highest participation, at 61%, and psychiatry had the least, at 8%. Only 12% of family physicians reported that they participate in alternative payment models.

Despite the difficulties in both determining care costs and discussing those costs with patients, almost all family physicians (94%) said they sometimes (37%) or regularly (57%) talk with patients about cost of care.

And despite some dissatisfaction with pay and increasing hours spent on paperwork and administrative burdens, most said they made the right career choice: 73% said they would pick medicine as their career again. Cardiologists and pulmonary specialists had the highest proportion of respondents who said they would choose medicine again, both at 88%, whereas public health & preventive medicine physicians, nephrologists, and allergy & immunology specialists had the lowest percentage at 67%, 66%, and 62%, respectively.

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