The income of a general practitioner in France cannot be summarized in a single line. Between a private practitioner established in a rural area and a hospital doctor at the beginning of their career, the differences can sometimes exceed a factor of two to three. Understanding these disparities requires breaking down each source of income, from consultation fees to the packages paid by Health Insurance.
Average income of general practitioners: private, hospital, locum
The most recent data from DREES, published at the end of 2024 on 2023 incomes, provides a numerical framework. The table below summarizes the ranges according to the practice status.
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| Practice Status | Estimated Monthly Net Income | Particularities |
|---|---|---|
| Private (sector 1) | €4,500 to €5,500 | After expenses, before income tax |
| Hospital (full-time PH) | €5,000 to €7,000 (including on-call and bonuses) | Salary scale, progression based on seniority |
| Private locum | Variable, generally lower than the permanent practitioner | No own patient list, no annual packages |
For private general practitioners, the average annual activity income reaches €95,000 gross according to DREES. This figure masks very different realities depending on the geographical area, the volume of consultations, and the contracting sector.
The salary of a general practitioner in France also depends on supplements that are often underestimated in quick comparisons between statuses.
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ROSP and structure package: supplements that impact remuneration
The packages paid by Health Insurance represent a significant part of the annual income of a private general practitioner. Two schemes stand out.
The ROSP (remuneration based on public health objectives) reached an average of €5,361 per concerned doctor in 2024, an increase of 3.4% year-on-year. This amount rewards the achievement of clinical indicators (diabetes monitoring, chronic kidney disease screening, prescriptions in the generic directory).
The structure package, paid as a supplement, compensates for the equipment of the office and the organization of the practice (teletransmission software, hiring a medical assistant). By combining ROSP and the structure package, the 51,202 general practitioners concerned received an average of €9,563 in 2024, representing a 2.6% increase compared to the previous year.
- The ROSP alone represents the equivalent of one month of net income for some practitioners with a low volume of consultations.
- The structure package averages €4,181 per doctor, a direct lever for practices investing in care coordination.
- These two packages are paid in the spring of the following year, creating a cash flow lag that is sometimes poorly anticipated by newly established practitioners.
Many comparisons are limited to turnover or overall average income. Including these packages in the analysis changes the perspective, especially for general practitioners working in underserved areas where specific bonuses are added.
Sector 1, sector 2, and practice area: the real factors of disparity
The vast majority of general practitioners work in sector 1 (regulated fees). The base consultation fee has risen to €30 under the 2024-2029 medical agreement, after years at €25. This increase has mechanically raised the average turnover.
In sector 2, the practitioner freely sets their fees, with regulated or unregulated excess fees depending on the controlled pricing practice option (OPTAM). However, the proportion of general practitioners in sector 2 remains low compared to specialists. The income gap between the two sectors exists, but it is mitigated by the fact that patients in sector 2 benefit from lower reimbursements, which limits the potential patient base.
The location of the practice plays at least as significant a role. A general practitioner in a priority intervention area has access to installation aids and specific bonuses. In contrast, a practitioner in the city center of a large metropolis faces denser competition and high overhead costs, which compresses net income.
Hospital salary of the general practitioner: beyond the salary scale
Reducing the remuneration of a hospital practitioner to their base salary is misleading. The salary scale of a full-time PH starts relatively low at the beginning of a career, but several elements supplement this base.
- Night and weekend on-calls add several hundred euros per month depending on frequency, sometimes more than a thousand.
- Territorial exercise or public service commitment bonuses target practitioners accepting assignments in underserved areas.
- The sectoral and liaison activity allowance (IASL) concerns doctors performing cross-service missions.
Taking these supplements into account, the real income of a hospital general practitioner ranges between €5,000 and €7,000 net per month. The gap with private practice narrows when considering the social and professional charges that the private practitioner bears alone, while the hospital practitioner benefits from employer coverage.
Seniority remains the main lever for progression in the hospital environment. A PH at the end of the scale receives a gross salary significantly higher than that of a young practitioner, not to mention the possibilities of combining with a private practice for those working in mixed practice.
DREES data confirms that the income gap between doctors can exceed a factor of 7 depending on status, specialty, and geographical area. For a general practitioner, this factor remains more moderate than for certain surgical specialties, but it is enough to create very different financial trajectories from one practitioner to another. The recent increase in the consultation fee and the revaluation of the packages initiate a catch-up, the concrete effects of which on installations in tense areas remain to be measured.