Primary Care Trails Other Specialties in Hourly Wages

In other study, physicians point to Medicare reimbursement problems, differ on reforms
By Eric Metcalf
HealthDay Reporter

TUESDAY, Oct. 26 (HealthDay News) -- Primary care physicians have substantially lower hourly wages than other specialists, and although most physicians find Medicare reimbursement inequitable, they show little consensus on how to reform it, according to two studies published in the Oct. 25 issue of the Archives of Internal Medicine.

In the first study, J. Paul Leigh, Ph.D., of the University of California Davis School of Medicine, and colleagues analyzed data from 6,381 physicians in the 2004 to 2005 Community Tracking Study, focusing on earnings per hour. They found that, compared to primary care specialties, wages for surgery, internal medicine and pediatric subspecialties, and other specialties were 36 to 48 percent higher.

In the second study, Alex D. Federman, M.D., of the Mount Sinai School of Medicine in New York City, and colleagues analyzed data from a survey of 1,222 physicians. They found that 78.4 percent of physicians felt that some procedures were compensated too highly and others too poorly under Medicare. In terms of possible reimbursement reforms, those receiving relatively high support were financial incentives for quality (49.1 percent) and shifting payments from procedures to management and counseling services (41.6 percent). Most respondents from all specialties opposed bundled payments for episodes of care.

"As Federman et al allude, payment reform will surely generate some provider backlash, and surely bundled payments will create tension between physicians and other types of providers, among different specialties, and between primary care and specialist physicians. Moreover, the transition to new payment systems may not be easy, requiring considerable investment and organizational change," writes the author of an accompanying commentary.

Abstract - Leigh
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Abstract - Federman
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