A new American Medical Association (AMA) report depicts how shifting the nation’s health care system from a fee-for-service, payment-based model to another model could be difficult because nearly one-third of all physician compensations are based on personal productivity, which might incentivize quantity over quality. Specifically, the report noted that:

  • 51.8 percent reported one revenue source;
  • 30.3 percent said they have two revenue streams;
  • 13.2 percent reported having three sources of revenue; and
  • 4.7 percent said they had four income sources.

Meanwhile, 20 percent of respondents said their salary was their only sources of income, and about 33 percent said their salaries made up the bulk of their income but was not 100 percent of it. About 22 percent said their income was based entirely on personal productivity, while 10.1 percent said compensation based on personal productivity was the bulk of their income. Among employed (faculty, hospital, etc.) physicians:

  • 32 percent said their salaries made up their entire incomes;
  • 40.7 percent said salaries were the largest portion of their incomes;
  • 16.3 percent reported that their entire income was based on personal productivity; and
  • 5.8 percent said personal productivity accounted for the bulk of their income.

The report concluded that it might be “difficult to align practice-level incentives that encourage judicious use of resources with physician-level incentives that do not.”