1 / 39

Finances and the Family Physician The Reality of Primary Care Compensation

Finances and the Family Physician The Reality of Primary Care Compensation. Emily Adams, BA, and John Wiecha, MD, MPH Boston University School of Medicine Department of Family Medicine – Boston Medical Center. What is the scope of Family Medicine?.

elke
Download Presentation

Finances and the Family Physician The Reality of Primary Care Compensation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Finances and the Family PhysicianThe Reality of Primary Care Compensation Emily Adams, BA, and John Wiecha, MD, MPH Boston University School of Medicine Department of Family Medicine – Boston Medical Center

  2. What is the scope ofFamily Medicine? American Board of Family Medicine Official Definition of Family Medicine “Family medicine is the medical specialty which provides continuing, comprehensive health care for the individual and family. It is a specialty in breadth that integrates the biological, clinical and behavioral sciences. The scope of family medicine encompasses all ages, both sexes, each organ system and every disease entity.” https://www.theabfm.org/about/policies.aspx

  3. History of Family Medicine 1946 AMA established a section on General Practice to give voice to the mounting problems and decreasing numbers of generalists. Section develops into American Academy of General Practice. 1966 Three independent reports supporting the value of the practice of family medicine were published: the Millis Report, the Folsom Report, and the Willard Report They called for a “a physician who focuses not upon individual organs and systems but upon the whole man, who lives in a complex setting…”, and whose “relationship with the patient must be a continuity one” https://www.theabfm.org/about/history.aspx

  4. History of Family Medicine(continued) The specialty was formed because of the dwindling number of medical school graduates entering general practice and the difficulty of general practitioners without board certification acquiring hospital privileges 1969 The American Board of Family Practice was officially recognized in February as the 20th primary medical specialty with 15 pilot programs 1971 The American Academy of General Practice became the American Academy of Family Physicians 1984 Family Practice became the third largest residency with 380 programs https://www.theabfm.org/about/history.aspx

  5. Training in Family Medicine • Residency Training – 3 years • 497 accredited programs (2005) • Broadest curriculum of all specialties Rotate through internal medicine, obstetrics, gynecology, surgery, emergency medicine, critical care, and psychiatry as well as other medical and surgical subspecialties • Includes training in both inpatient and outpatient care and a longitudinal patient load

  6. Total level of debt of Family Medicine Residency Graduates Median Level of Debt = $163,000 American Academy of Family Physicians, Annual Residency Completion Survey, 2005

  7. Examples of Possible Fellowships after Family Medicine Residency • Community Health • Faculty Development • FM/Psychiatry • Geriatrics • Hospitalist • Integrative Medicine • Minority Health • Obstetrics • Palliative Care • Preventative Medicine • Research • Rural Medicine • Sports medicine • Substance Abuse • Urgent Care • Women’s Health

  8. Certificate of Added Qualifications Adolescent Medicine Geriatric Medicine Hospice and Palliative Medicine Sleep Medicine Sports Medicine

  9. Procedures Done by Family Physicians Non-Cosmetic Procedures Cosmetic Procedures Chemical Peel Laser Hair Removal Botox Sclerotherapy Microdermabrasion Cryotherapy • Minor office surgery • Joint injection and aspiration • Surgical assisting • Intubation skills • Lumbar puncture • Chest tube placement • Thoracentesis • Anterior and posterior nasal packing • Tendon repair • Central line placement • Casting • EKG interpretation • Colposcopy • OB ultrasound • Cesarean sections • Vasectomies • Circumcisions • IUD insertion • Endometrial biopsy • Breast biopsy • Stress testing

  10. Geographic Distribution of ABFM Certified Doctors (August 2006) https://www.theabfm.org/about/stats_us.aspx

  11. Practice Type of Family Doctors https://www.theabfm.org/about/stats_practice.aspx

  12. In What Contexts Do Family Physicians Practice? Most Family Medicine Residency Graduates are Office Based Note: Based on a January 1, 2006 survey of 32,566 family medicine residency graduates. Source: American Academy of Family Physicians

  13. In What Contexts Do Family Physicians Practice Versus Other Specialties? Family Medicine Pediatrics Internal Medicine Source: 2006 Practice Survey - Merritt, Hawkins & Associates http://www.merritthawkins.com/pdf/MHA2006SurveyofPrimaryCarePhysicians.pdf

  14. Average number of patient contact hours per week by family physicians (October 2006) Source: American Academy of Family Physicians, Practice Profile I Survey, October 2006 http://www.aafp.org/online/en/home/aboutus/specialty/facts/14.html

  15. Average number of family physician visits per week and average number of patients in various settings(October 2006) Average Visits Per Week Source: American Academy of Family Physicians, Practice Profile I Survey, October 2006 http://www.aafp.org/online/en/home/aboutus/specialty/facts/5.html

  16. How Are Family Physicians Paid?Six Models of Physician Compensation http://www.aafp.org/fpm/981000fm/cover.html

  17. How Are Family Physicians Paid?Six Models of Physician Compensation(continued) http://www.aafp.org/fpm/981000fm/cover.html

  18. What Do Family Physicians Actually Make? And Which Family Physicians Make More?

  19. Salary in Residency Average salaries offered (in dollars), 2002-2003 http://www.aafp.org/online/en/home/aboutus/specialty/facts/23.html

  20. Median and Mean 2005 Income of Family Physicians(Before Taxes) • Data collected October 2006 • Presented by Demographic Categories • Data includes Full-time and Part-time Physicians • http://www.aafp.org/online/en/home/aboutus/specialty/facts/15.html

  21. Salary by Census Division (2005) http://www.aafp.org/online/en/home/aboutus/specialty/facts/15.html

  22. Salary by Practice Type (2005)

  23. Salary by Gender (2005)

  24. Salary by Practice Location (2005) http://www.aafp.org/online/en/home/aboutus/specialty/facts/15.html

  25. Salary by Age of Physician (2005) http://www.aafp.org/online/en/home/aboutus/specialty/facts/15.html

  26. Yearly Salary by Different Practice Traits (2005 Physician Salary Survey Report) Low, median and high represent the 25th, 50th, and 75th percentiles. Copyright 2005 - Hospital & Healthcare Compensation Service and John R. Zabka Associates

  27. Distribution of Family Physician Incomes (After Expenses)2002 AAFP demographic survey

  28. Comparison of National Annual Incomes of Family Practice vs. General Practice2005 Physician Salary Survey Report Low, median and high represent the 25th, 50th, and 75th percentiles. Copyright 2005 - Hospital & Healthcare Compensation Service and John R. Zabka Associates

  29. Factors that Increase Earning in Family Medicine From a survey of 730 active AAFP members who had been out of residency five years or longer and worked at least 40 hours per week. • High-earners: Those with 2003 pre-tax individual incomes of more than $160,000 after expenses • Low-earners: Those with 2003 pre-tax individual incomes of less than $160,000 after expenses www.fotosearch.com

  30. Factors that have a Large Association with High EarningIn order of significance 1) Providing more patient visits(high-earners saw a mean number of 122 patients per week; low-earners saw 84) 2) Practicing the full scope of family medicine in the hospital setting 3) Being in larger practices(which may be related to the next four factors) 4) Providing clinical lab, physical therapy, occupational therapy and imaging services in-house 5) Viewing negotiations with payers and evaluating contracts as very important

  31. Factors that have a Large Association with High EarningIn order of significance (continued) 6) Participating in quality improvement, marketing, strategic planningand benchmarking 7) Having in-house billing and collections 8) Seeing more Medicare patients (nationally, may vary by state) 9) Working more hours 10) Being paid based on productivity 11) Planning to purchase an EHR

  32. Factors that Do Not Have a Significant Impact on EarningIn no particular order • Current use of an EHR • Number of staff meetings • Practice management courses for physicians or staff • Educational level of in-house billing staff • Fee-for-service versus capitated revenue • Percentage of co-payments collected at the time of service • Aging of accounts receivable

  33. How does Compensation in Family Medicine compare to other Primary Care Specialties? What is the current demand for Primary Care Doctors?

  34. Primary Care Internal Medicine Comparison between Different Specialties All Physicians vs. Starting Physicians2006 AMGA Compensation Survey http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

  35. Primary Care Internal Medicine Comparison between Different Specialties (By Region) 2006 AMGA Compensation Survey http://www.cejkasearch.com/compensation/amga_physician_compensation_survey.htm

  36. Primary Care Internal Medicine Income Trends by Specialty - 2005Presented by Percentage of Physicians in Income Brackets

  37. Current Demand for Family Physicians “MOST WANTED For the first time in six years, general internists and family physicians are at the top of the ‘in demand’ list for hospitals and medicals groups, according to a review of 2,840 Merritt, Hawkins & Associates’ listings. Here by year are the number of physician searches by specialty starting in 2002-03 and continuing through 2005-06.” AMA News June, 2006

  38. Current Demand forFamily Physicians “According to Merritt, Hawkins & Associates’ 2005 Survey of Hospital Physician Recruiting Trends, more hospitals are actively engaged in recruiting family physicians than any other type of physician.” - Leslie Champlin – AAFP News Now (7/25/06)

  39. Future EarningPotential “It isn't unusual for students to hear that physicians working in family medicine don’t make enough to pay off their loans. However, the truth is that family physicians make enough money to pay off student loans and have the lifestyle they want.” “In the future, incomes for family physicians are projected to increase as much as 25% in practices that use new technologies and new care models, such as chronic disease management.” Debt Management – Publication of American Academy of Family Physicians, 2007 http://www.aafp.org/online/en/home/publications/otherpubs/debtmgmt.html

More Related