• 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

    Specialist Average number of patient visits/week, 1999 Net Income after expenses, before taxes, 2000
    Family Physician 122.9 $144,700
    General Pediatrician 120.5 $137,800
    General Internist 106.5 $164,100
    Gastroenterologist 89.9 $299,200
    Cardiologist 92.4 $315,500
    Orthopaedic Surgeon 114.3 $335,800
    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, Oct 15, 2003. Am Fam Physician. 2003;68(12):1486. This series is coordinated by Sumi Sexton, MD, AFP Associate Medical Editor.