The U.S. Primary Care Physician Workforce: Undervalued Service

One Pagers | Oct 15, 2003 Holly Biola, MD; Larry Green, MD; Robert Phillips, MD MSPH; Janelle Guirguis-Blake, MD; Ed Fryer, PhD

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.

Source: The National Ambulatory Care Surveys 1980-1999

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

Average Number of Patient Visits/week (1999) and Net Income Before Taxes (2000) by Specialty

SpecialistAverage number of patient visits/week, 1999Net Income after expenses, before taxes, 2000
Specialist: Family PhysicianAverage number of patient visits/week, 1999: 122.9Net Income after expenses, before taxes, 2000: $144,700
Specialist: General PediatricianAverage number of patient visits/week, 1999: 120.5Net Income after expenses, before taxes, 2000: $137,800
Specialist: General InternistAverage number of patient visits/week, 1999: 106.5Net Income after expenses, before taxes, 2000: $164,100
Specialist: GastroenterologistAverage number of patient visits/week, 1999: 89.9Net Income after expenses, before taxes, 2000: $299,200
Specialist: CardiologistAverage number of patient visits/week, 1999: 92.4Net Income after expenses, before taxes, 2000: $315,500
Specialist: Orthopaedic SurgeonAverage number of patient visits/week, 1999: 114.3Net Income after expenses, before taxes, 2000: $335,800
Specialist: Source: AMA Physician Socioeconomic Statistics, 2003 Edition, p.186, 188, and 193.

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. 

Published in American Family Physician, Oct15, 2003. Am Fam Physician. 2003;68(12):1486. This series is coordinated by Sumi Sexton, MD, AFP Associate Medical Editor.