A general practitioner setting up in private practice in a rural community and a hospital practitioner nearing retirement in Lyon do not earn the same amount at the end of the month. The disparities can sometimes exceed a factor of seven between the lowest and highest situations. Understanding these incomes requires distinguishing several indicators that official sources do not measure in the same way.
Activity income and net income: two figures, two realities
We often read very different amounts for the same profession. The reason lies in the indicators used. The DREES publishes an average annual activity income of around 95,000 euros for a liberal general practitioner. The CARMF, on the other hand, reports an average net independent activity income of 89,238 euros for 2023.
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The difference comes from what each organization includes or excludes in its calculation: social contributions, office expenses, staff costs. The actual disposable income remains far from the gross revenue. A liberal general practitioner who earns 150,000 euros a year may end up with half of that after deducting expenses, Urssaf contributions, and CARMF fees.
To know precisely how much a general practitioner earns per month, we must always specify which income we are referring to: gross activity, net before income tax, or net after tax.
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Reform of the Urssaf deduction: what changes on the liberal’s payslip
Since 2025, the Urssaf reform concerning the flat-rate deduction of 26% modifies the calculation of social contributions for liberal doctors. In practice, the social base increases for those who deducted more actual expenses than this flat rate. The gross revenue remains the same, but the final net income decreases.
Specialized accountants in health professions report that the impact varies depending on the profile of the practice. A general practitioner in sector 1 working alone, with few fixed costs, may see their contribution increase significantly. A practitioner in a multi-professional health center, whose structural costs are higher, will be less affected.
This reform reminds us that we cannot compare liberal incomes from one year to the next without checking the current tax and social rules. An income that appears stable may mask a real loss of purchasing power.
Salary of a general practitioner in the hospital: on-calls and bonuses in the calculation
A hospital practitioner (PH) starting at the first level earns about 3,500 euros net per month. At the end of their career, at the thirteenth level, this amount rises to around 7,000 euros net monthly. These figures are before income tax.
On-calls and bonuses radically change the comparison with private practice. A PH who takes on numerous night and weekend on-calls can see their monthly remuneration significantly exceed their base salary. Recent sources now more clearly distinguish between base salary and total income including on-calls, making the reading more honest.
In private clinics, the ranges are between 4,500 and 6,500 euros net per month in permanent contracts. The volume of on-calls is generally lower, but the additional remuneration (profit-sharing, benefits in kind) varies greatly from one establishment to another.
Replacement doctor: high income, low stability
Replacement work attracts many young doctors. We observe remuneration around 500 euros net per day, or about 7,500 euros net per month for fifteen days worked. On paper, it is one of the most lucrative statuses.
However, the ground reality tempers this observation. A replacement doctor faces:
- The absence of a personal patient base, meaning no guarantee of regular income from month to month
- Sometimes heavy travel expenses, especially in rural areas where the demand for replacements is highest
- No automatic supplementary retirement contribution unless they organize it themselves with the CARMF
- Full financing of insurance coverage, unlike hospital practitioners
The high daily income masks a structural precariousness that many replacements discover after a few months of practice. Feedback varies on this point, but the transition to a permanent position remains the majority choice in the medium term.
Practice area and remuneration of general practitioners in France
The income of a general practitioner varies greatly depending on their practice area, and several concrete mechanisms explain these disparities.
In under-served areas, installation aids (public service commitment contracts, tax exemptions) significantly increase net income. A general practitioner who sets up in a medical desert can benefit from supplements that do not exist in densely populated urban areas.
Conversely, in large metropolitan areas, the higher medical density implies a potentially lower patient base per doctor. Office rental costs are also significantly higher. A general practitioner in a rural area can generate a net income higher than that of a Parisian colleague, despite a comparable volume of consultations.
Additional remuneration also plays a often underestimated role:
- Public health objective remuneration (ROSP), which rewards the monitoring of certain prevention indicators
- The patient base fee for the treating physician, revalued by the 2024-2029 medical convention
- Specific aids for fragile areas, which can be combined with other schemes
These supplements represent several thousand euros per year, and the averages published by the DREES or CARMF do not systematically include them in their calculations.
The income of a general practitioner depends less on clinical talent than on the chosen status, geographic area, and mastery of tax and social mechanisms. Comparing a liberal sector 1 practitioner in Creuse and a PH in Marseille only makes sense when aligning the same indicators. A 30% gap between two profiles may solely depend on the calculation method used, not on a real difference in living standards.