Survey: Primary care generates more hospital revenue than specialists


Primary care physicians generated more net hospital revenue on average than did specialists in 2013, marking the first time primary care doctors surpassed specialists in hospital revenue generated, according to a survey of hospital chief financial executives from physician job placement firm Merritt Hawkins.

The increases in revenue generated by family physicians and internists could result from recent trends toward hospital employment of physicians, Merritt Hawkins said in its analysis.

Primary care physicians generated average revenue of $1.57 million each, up about 13% from $1.38 million in 2010, the survey showed. Meanwhile, specialists generated $1.42 million, the lowest average in the 5 years Merritt Hawkins has conducted the survey.

The average annual net revenue generated by individual physicians in all 18 specialties was $1.44 million, a decrease of 9% over average annual net revenue generated by all specialties in 2010 – again, the lowest average number in the survey’s 5-year history.

In primary care, family physicians saw a 22% gain in hospital revenue generated, to an average of $2.1 million per physician, while internists saw 9% gains, to $1.8 million. Pediatricians, meanwhile, had slight losses in hospital revenue generated between 2010 and 2013.

"As primary care physicians become hospital employees, they may be more likely to divert tests, therapies, and other services ‘in-house’ to their hospital employer, rather than to outside resources such as radiology groups or labs, which may have been their pattern when they were in independent practice," the survey authors said.

Gains in revenue generated by family physicians and internists also may result from delivery models’ shifts toward a primary care-driven approach.

Some specialty areas – notably, nephrology – saw significant gains in net hospital revenue between 2010 and 2013. Nephrologists generated an average of $1.17 million each in 2013, a gain of 69% over 2010, the report said. Orthopedic surgeons also generated more revenue for hospitals, as did hematologists/oncologists.

Meanwhile, the survey noted declines in average annual revenue generated by neurology, general surgery, and neurological surgery. Average hospital revenue generated also declined slightly in invasive cardiology, the survey found. Average annual revenue generated by urology, pulmonology, obstetrics/gynecology, and psychiatry was more or less stable in 2013, compared with 2010.

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