Family Physicians Have Lowest Incentive Bonuses, Survey Finds

Marcia Frellick

May 21, 2020

Family physicians had the lowest incentive bonuses of any specialty, according to the Medscape Family Medicine Physician Compensation Report 2020.

This year's survey was the first to ask about bonuses, and it showed strong contrasts between specialties. Family physicians' bonuses averaged $24,000, whereas orthopedists' were four times higher, at $96,000.

Two thirds of family physicians (67%), similar to physicians overall, reported the bonuses had no influence on the number of hours worked.

More than half of all physicians in the survey (56%) said they got such bonuses.

Family physicians' pay was up $3000 from last year, to $234,000, but still ranked near the bottom in comparison with other specialties. Only physicians in public health/preventive medicine and pediatrics made less, both at $232,000.

The top four specialties in pay were the same this year as they were last year and ranked in the same order: orthopedists made the most, at $511,000, followed by plastic surgeons ($479,000), otolaryngologists ($455,000), and cardiologists ($438,000).

However, the compensation picture is changing for all physicians. This report reflects data gathered between October 4, 2019, and February 10, 2020. Since that time, the COVID-19 crisis has reversed income gains for physicians overall. In a study from the Medical Group Management Association, researchers estimate that more than half of medical practices reported a drop in revenue by early April of 55% and a drop in patient volume of 60%.

Male family physicians continue to make more than their female colleagues, with this year's difference at 26% ($257,000 vs $205,000). Male specialists overall in the survey made 31% more than their female counterparts.

Few Claims Denied

A bright spot in compensation was that family physicians have among the lowest rates (14%) of claims that are denied or that need to be resubmitted. Plastic surgeons have twice that rate (28%) of rejected claims.

The survey authors note, "One study found that, on average, 63% of denied claims are recoverable, but healthcare professionals spend about $118 per claim on appeals."

Family physicians were in the middle of the pack as far as how much time was spent on paperwork. On average, they spent 15.9 hours a week on the tasks. Intensivists spent the most, at 19.1 hours each week, and ophthalmologists spent the least, at 9.8 hours per week.

Although 73% of physicians overall said they had no plans to stop accepting new and current Medicare and Medicaid patients, only 65% of family physicians answered that way. Seventeen percent said they would stop taking new Medicare patients, and 9% said they wouldn't take new Medicaid patients; 15% had not made those decisions yet.

Rules and Regulations Are the Biggest Challenges

Asked about their biggest challenges, 29% of family physicians put "having so many rules and regulations" at the top. Next came working with an electronic health records system, followed by dealing with difficult patients.

The biggest reward, they said again this year, was "gratitude/relationships with patients" (34% ranked it at the top), followed by "knowing I'm making the world a better place" (25%), "being very good at what I do/Finding answers, diagnoses" (18%), and "making good money at a job that I like" (10%).

Most family practices employ advanced practice providers (62% employed NPs, and 43% employed PAs). Fewer than one third employed neither.

Of the family medicine physicians who did work with advanced practice providers in their offices, half (50%) said they improved profitability, 45% said they had no effect, and 5% said they decreased profitability.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune and Nurse.com and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick.

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