Compensation and Production in Family Medicine by Practice Ownership.

Area of Science:

• Health Services Research
• Primary Care Medicine
• Healthcare Management

Background:

• The healthcare landscape is shifting towards high-performance, patient-centered, team-based primary care.
• Physician practice consolidation presents challenges to the existing primary care system.
• Evaluating cost-effectiveness and provider value is crucial for resource allocation.

Purpose of the Study:

• To assess and compare the productivity and compensation of physicians, physician assistants (PAs), and nurse practitioners (NPs) in primary care settings.
• To inform decision-making regarding resource allocation and team composition in evolving healthcare systems.

Main Methods:

• A national survey of family medicine practices was conducted.
• Data collected included mean annual patient encounters (productivity) and total compensation (salary, bonus, incentives, honoraria).
• Analyses considered practice ownership (physician-owned vs. hospital/integrated delivery system-owned).

Main Results:

• Physician assistant (PA) productivity, measured by patient encounters, surpassed that of nurse practitioners (NPs) and physicians in physician-owned practices.
• PA productivity also exceeded NP productivity in hospital or integrated delivery system-owned practices.
• Physicians received significantly higher total compensation than PAs and NPs, irrespective of practice ownership or productivity.
• PAs and NPs earned equivalent compensation, independent of practice ownership or productivity.

Conclusions:

• Data affirm the significant value and role of PAs and NPs within the primary care team.
• Differences in patient encounter volumes highlight variations across practice settings.
• Further research is recommended to guide organizational and policy decisions for high-quality, cost-effective, and accessible primary healthcare, particularly in rural and underserved areas.