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Investing in our Providers

Doctors have always been held in high regard; it is the most common professional endeavor among five year olds everywhere, that is, until they grow up and realize they must complete the daunting task of medical school (not to mention residency) before their practice even begins. By that time, that fearless five year old is well into his/her 30s. The process is by no means a race, but a very expensive marathon, one requiring commitment and sacrifice.

Nonetheless, the profession is respected among many, taken on by those honorable in character that believe its fruit will be both rich in satisfaction and payment.  Or is it?

In the 2012 Medscape Physician Compensation report, 49% of physicians and 54% of primary care providers (PCPs) felt unfairly compensated. The report found that physician income declined in general, but radiologist and orthopedic surgeons continued to lead the earning pack at $315,000 while family medicine doctors and pediatrician trailed behind at $158,000 and $156,000, respectively. The chart below depicts physician compensation in 2011.

The survey also reported on physician compensation by practice setting, finding that partners in private practices earn much more ($308,000) than those practicing solo or those working as employees (see chart below).

When considering the commitment necessary to power through medical school and residency training, in addition to the optimism in one’s ability to pay off the hundreds of thousands of dollars of student loan debt[1], coupled with the constant threat of funding cuts to physician reimbursement rates, it is not surprising, but painfully clear why physicians feel unfairly compensated.

The ACA provides an opportunity for states to invest in its doctors. For example, the federal government will foot the bill to increase Medicaid PCP reimbursement rates to Medicare levels in 2013 and 2014. This will help encourage physicians to participate in Medicaid and promote greater access to primary care for beneficiaries. California should take full advantage of this opportunity by figuring out how to maintain the increased payment rate. The state should also become more cautious in its natural tendency to reduce reimbursement rates as a means to alleviate deficit problems, as with the current budget proposal to reduce payment to Health Families managed care plans by 25.7%. If California is committed to achieving the ACA’s goal of improving access to care, a greater investment in the workforce has to be made, and it should start with fair compensation for providers.


To view the full report by Medscape, click here.

For an overview of HHS’s proposed rules for the Medicaid primary care rate increase, view this fact sheet prepared by the Center for Health Care Strategies.

[1] A 2009 U.S News survey found that the typical medical student graduates with $141, 132 in debit while others average more than $200,000 in loans. See, http://www.usnews.com/education/best-graduate-schools/articles/2011/04/14/10-medical-schools-that-lead-to-most-debt


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