Report: 'Society simply doesn't value primary care'

By a wide margin, specialists are paid more than doctors in general practice, according to an independent report released Monday.

In a nationwide survey, researchers at the University of California, Davis, found medical specialists are paid as much as 52 percent more than primary-care physicians.

The trend — while hardly news within the medical community — nonetheless quantifies some of the gaps in physician compensation that are encouraging more physicians to enter lucrative specialties and avoid general practice. 

The result is not only much higher healthcare costs for everyone, the researchers warn, but a less healthy population as patients lose access to preventive care services. 

"Addressing the generalist-specialist income gap is critical to increasing access to cost-effective preventive care," J. Paul Leigh, professor at the UC Davis Center for Healthcare Policy and Research and lead author of the study, said in a statement. "There is a huge shortage of primary-care physicians, and in years to come many more of them will be needed to meet health-care reform goals."

After examining the wages of more than 6,000 physicians nationwide, researchers compared hourly wages of various specialties versus primary-care doctors — a break from many other compensation studies that have focused on annual pay.

The findings, based on figures from 2004 and 2005:

• Primary-care doctors — including those focused on pediatrics, geriatrics, family practice and internal medicine — made $60.48 per hour.

• Internal medicine and pediatric sub-specialists — including those focused on immunology, gastrointestinal conditions, cardiovascular diseases, rheumatology, pulmonary medicine, critical care, medical oncology and neonatal care — pulled in $84.85 per hour.

• Other specialists — like those focused on radiation oncology, rehabilitation, emergency medicine, psychiatry, neurology, ophthalmology and dermatology — made $88.08 per hour.

• Surgeons brought in $92.10 per hour.

The difference between the primary-care and specialist salaries adds up to millions of dollars over the physician's lifetime, according to Richard Kravitz, a professor of internal medicine and investigator with the Center for Healthcare Policy and Research. 

"There is this sense that society simply doesn't value primary care," Kravitz said.

The study was published in the latest issue of the journal Archives of Internal Medicine.