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Income gap between primary care, specialties threatens healthcare

Physician Practice Advisor, February 28, 2007

The income gap between primary care and medical specialties is discouraging medical school graduates from choosing primary care careers and threatening the U.S. healthcare system, according to an article in the Annals of Internal Medicine.

Some specialists earn almost twice as much as primary care physicians (PCPs) working the same amount of hours. The Resource-Based Relative Value Scale was designed to reduce the inequality between fees for primary care office visits and specialty procedures. However, according to the article, it failed to prevent the widening primary care-specialty income gap for the following reasons:

The volume of diagnostic and imaging procedures has increased far more rapidly than the volume of office visits, benefitting specialists who perform those procedures
The Relative Value Scale Update Committee, which updates fees every five years, is composed mainly of specialists
Medicare's formula for controlling physician payments penalizes PCPs
Private insurers tend to pay for procedures, but not for office visits, at higher levels than those paid by Medicare

Click here to access an abstract of the article.

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