Primary Care Docs Average More Hospital Revenue Than Specialists

John Commins, for HealthLeaders Media , May 20, 2013

"In theory, if that happens, then that is where you want to invest all of your dollars, because not only are you controlling the outcome, but you are controlling the expense of your specialists."

Even with the newfound emphasis on primary care, key specialties remain top revenue generators for hospitals. Orthopedic surgeons topped the list of specialists examined in the survey. A single, full-time orthopedic surgeon generates an average of $2,683,510 a year. Invasive cardiologists generate $2,169,643, general surgeons $1,860,655, and neurosurgeons $1,684,523, the survey found.

Singleton says he's not sure how long the trend toward higher average revenues will continue for physicians.

"We know the employed physician sees 17% fewer patients than their private counterpart, and it's greater in some specialties. So it wouldn't surprise me if we looked in two or three years from now and the actual revenue per provider was down in some scenarios," he says.

"That doesn't mean the whole pie is smaller. You may have the same amount of revenue but you just may take more primary care providers to generate the same revenue, or you may see some that are leaked towards a nurse practitioner or a physician assistant as they start to grow these networks. But these are all new networks for hospital to control in a lot of cases."

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4 comments on "Primary Care Docs Average More Hospital Revenue Than Specialists"

RB (5/21/2013 at 12:49 PM)
Misleading conclusions, I agree. One conclusion I drew without knowing more facts than published in this article is that primary care doctors order more tests compared to specialists who perhaps practice more cost-efficient medicine. I'm a cardiologist and once, in a past life employed at a local hospital, I was told during my review that I didn't order enough echoes (based on what they expected when they hired me). Not every heart problem requires an echo to diagnose or treat.

Mary O'Brien (5/20/2013 at 3:04 PM)
"We recognize that the majority of this bump is because more of their physicians are employed now so there is greater control," he says. "These health systems have formulated these vast employee networks and it is no secret that an employed physician is going to be much more apt and even directed in some cases to push a lab or a test or a procedure or a referral down the hall and not down the street. They aren't going to send it to an independent imaging group or an independent lab like they used to. In essence that is not really creating new money. That is just pulling that money within the hospital walls." This comment also raises the issue that all these ancillary services being driven into the hospital setting by employed physicians will increase the cost of health care . The same service performed in the outpatient settings of independant providers are in most cases much more cost effective than when performed in the hospital setting.

P.Yadav (5/20/2013 at 2:16 PM)
Acquisition of small practices by bigger hospitals is the norm leaving the combined revenue unquestionably greater. It is important to point out that it takes a lot (time,energy,capital,risk)to establish a specialty clinic/practice hence, fewer available for acquisition. Most specialists like to work as employees from the beginning of their career. The difference in revenue may have to do more with market forces playing out than the so mentioned automatic shift of power towards PCPs in healthcare. I agree with the comment above- Several questions are left unanswered like how the revenue was calculated, did it include the referral cut for in hospital PCPs?




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