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The primary care productivity squeeze

Primary care physicians are caught in productivity squeeze

Increasing costs and declining reimbursements are forcing primary care physicians to work harder for the same amount of money or simply take home less pay, according to a pair of recent surveys.

The year 2003 was the third consecutive year that increases in production outpaced increases in compensation, according to the Medical Group Management Assn.’s 2004 Physician Compensation and Production Survey.

The current economic plight of primary care is sending shockwaves through physician offices everywhere, as clinics struggle to keep up with rising costs and try desperately to find physicians willing to put in extraordinary hours.

“I’m hearing this at every chapter I visit: ‘I’m working harder, I’m putting in longer hours, I have trouble recruiting, my overhead keeps going up,’ ” said Mary Frank, MD, a family physician in Rohnert Park, Calif., and president-elect of the American Academy of Family Physicians. “The corollary is they’re cutting back as much as they can, but that affects the customer service aspect.”

According to the MGMA survey, the median compensation for all primary care physicians was $156,902 in 2003, a 2.4% increase over the $153,231 reported in 2002. Median gross charges, meanwhile, were $466,283, a 6.1% increase over the 2002 total of $439,347.

Now most non-physicians will look at the primary care physician median compensation and wonder, “what are they complaining about?” Remember that one does not start earning money until 4 years of college, 4 years of medical school and at least 3 years of residency. Most physicians start practice with huge debts. So the compensation numbers look great, but given the number of hours, and the accumulated debt, the numbers do not compare to specialists.

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