Holly Abernethy, MD
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A rough year for the U.S. economy had little negative impact on the income of physicians, according to the results of Medical Economics' 2009 Exclusive Survey. As the recession took hold and third-party payers tamped down on reimbursement, physician income
scarcely budged from 2007 to 2008.
According to the survey, which was administered in April and May to more than 100,000 office-based MDs and DOs in more than
16 specialties, median earnings for family physicians, internists, general practitioners, pediatricians, and ob/gyns remained
roughly the same in 2008 as they were in 2007. Among them, ob/gyns were the top earners, posting a median income of $237,500.
Pediatricians averaged $187,500, followed by FPs, GPs, and internists at $162,500.
Experiencing stable earnings from year to year is better than losing ground, but during tough economic times simply maintaining
income often means working harder and looking for innovative ways to boost revenue. Mary Jean Sage, a practice management
consultant with the Sage Associates in Pismo Beach, California, views the results in both a positive and negative light. 
What primary care doctors earn
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"I have had more calls in 2009 than I did in 2008 from physicians who say their patient load has decreased," she says. "Due
to the recession, patients have been more selective about going to physicians, and primary care practices are seeing a slowdown
in their appointment schedules—not only with regard to new patients, but established patients as well."
Sage notes that there was very little upward change in fee schedule reimbursement from Medicare and other third-party payers
in the past year, thus adding to the challenge.
The equation is balanced to a degree, she says, by a rise in practice startups in urban and rural areas that have long experienced
physician shortages, particularly in primary care. In general, she believes, "Physicians recognized the recessionary trend
early and were judicious about keeping their costs under control as much as possible to avoid a loss of profitability."
Family physician Holly Abernethy practices in Farmington, New Mexico, an area with "a huge primary care physician access problem,"
as she puts it. She earned about the same in 2008 as she did in 2007, but doing so required working additional hours during
the fall and winter months.
Soon, she'll be joining a new practice that offers her a partnership opportunity—though it comes with the tradeoff of lower
starting pay.
"A partnership is more important for me and my future," says Abernethy. "The opportunity for more money will come."
Jeffrey B. Milburn, a Colorado Springs consultant with the Medical Group Management Association, says that physicians who
earned more or roughly the same in 2007 and 2008 probably did so the old-fashioned way: by reducing expenses and increasing
productivity. He adds, however, that the "ripple effect" of increased unemployment—with expiring healthcare benefits and less
discretionary income—bodes poorly for physician earnings in 2009.
PHYSICIAN COMPENSATION 2008
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Survey respondent Ralph Boling, MD, knows this feeling well. The ob/gyn from Kirksville, Missouri, saw his income decline
between 2007 and 2008 despite workweeks of up to 60 hours.
"I still like my work," he says. "I just hate the payments. Medicaid—which pays about 10 percent of billed charges for gynecological
services, at best—and other third-party payers make it increasingly difficult to remain profitable."
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Posted 2009-09-29 00:25:38.0
