As the nature of physician compensation changes, one thing remains the same: disappointment by doctors with their current income.

Physicians Practice surveyed 1,474 physicians and staff for its annual Physician Compensation Survey, asking about personal income, practice overhead, practice outlook, and other financial issues. For the first time, the survey acknowledged the shift from volume-based reimbursement to value-based reimbursement, asking respondents to share how much of their income is tied to factors other than the number of patients they see.

Thirty-three percent of respondents said a portion of their compensation is tied to value (quality and cost of care provided) with 8.5 percent of that group saying this was the only factor in their pay. Furthermore, 24 percent of respondents said a portion of their compensation was tied specifically to patient satisfaction.

However, productivity remained the dominant factor in physician compensation, with 28 percent of survey respondents saying that their entire compensation package was factored on productivity alone. Another 37 percent said it comprised a portion of their annual pay.

For the third straight year, a majority of U.S. physicians described the income from their medical practice as "disappointing." In 2013, 54 percent defined their net income this way, the same number as a year earlier, but 5 percent more than those who tookPhysicians Practice's survey in 2011.

"In a time where so much is changing in healthcare, physicians would appreciate a steady stream of revenue to help adapt and survive in private practice," said Keith L. Martin, executive editor of Physicians Practice. "Unfortunately, overhead to run their practice is rising and reimbursements are remaining flat, if not falling, providing yet another reason physicians are considering employment, retirement, or simply shutting down their businesses. Fortunately, there are solutions to remain in private practice successfully."

Other data from this year's survey included:

• Seven out of 10 physicians are taking steps to boost revenue at their practices. Thirty-six percent have increased the number of patients seen each day and 26 percent have either added ancillary services or taken on work outside of their practice.
• Projecting the next one to five years, 12 percent of respondents said they may have to close their practice doors. In 2012, 8 percent voiced the same forecast for the coming one to three years.
• Of the 81 percent of respondents who accept Medicare, 70 percent said the uncertainty of federal payments has not affected their participation. Of the 71 percent with Medicaid patients, 70 percent said they will continue to see these patients in light of a healthcare reform-driven expansion — and temporary pay increase — from the federal government.

For the full results from our 2013 Physician Compensation Survey, including results by U.S. region, check out our data slideshow.