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2023 Physician Compensation Report

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No matter where they practice or what their specialty is, physicians want and need to know how their salary compares to others.

THE 2023 PHYSICIAN COMPENSATION REPORT ANSWERS QUESTIONS ABOUT:

  • Which physicians are highest-paid?
  • Can moving to a new city or state increase your compensation?
  • How does your specialty compare to other specialities and their compensation?
  • Are there biases in compensation?
  • Which are the highest-demand specialities?
  • Which regions of the country are hiring the most?
  • Where are physicians being offered the biggest bonuses?

We have saved you the trouble of spending countless hours sifting through expensive compensation reports that consist of hundreds of pages, as we have already done the hard work for you.

Our annual physician compensation report will save you time and money looking for the data and statistics you want to know.

HERE’S WHAT WE DETAIL IN THIS REPORT:

  • How physicians in different medical specialties and regions of the United States are being compensated
  • The gender wage gap
  • How much physicians are earning in incentives
  • Which specialties are in the greatest demand

We’ve compiled data from nearly a dozen different sources using current information to offer you the free Physicians Thrive 2023 Physician Compensation Report.

The Free Physicians Thrive 2023 Physician Compensation Report

Physicians’ salaries vary by region, specialty, gender, and a variety of other factors. From year to year, we see increases in certain regions, for certain specialties, and increasing bonuses in areas where there is a high demand for physicians.

We’ve broken down the compensation trends for physicians by specialty, region, gender, and by bonus incentives to provide insight into where salaries are increasing and where they’re decreasing.

Compensation by Region

Some of the same metro areas in the Northeast and South which have larger numbers of medical professionals and institutions, continue a trend of lower salaries.

Last year some lower-paying areas did increase pay, and now appear on the list of the top ten metro areas by percentage of pay increase. Rural areas also continue to pay some of the highest salaries in the country to attract medical professionals.

There are, however, some mid-sized metro areas that saw a salary increase. Buffalo and Boston saw significantly increased salaries. St. Louis, Virginia Beach, and Charlotte, NC all saw double-digit salary increases.

Metro areas with the biggest salary increases:

  • Charlotte +12.9%
  • Virginia Beach +12.1%
  • St. Louis +10.5%
  • Tampa +8.1%
  • Hartford +7.8%
  • Buffalo +7.4%
  • Sacramento +7.1%
  • Orlando +7.0%
  • Nashville +6.9%
  • Boston +6.1%

 Metro areas that pay the highest salaries:

  • Charlotte: $462,760
  • St. Louis: $452,219
  • Buffalo: $426,440
  • Jacksonville: $425,706
  • Orlando: $425,634
  • Minneapolis: $425,059
  • Milwaukee: $422,735
  • Phoenix: $419,359
  • Dallas: $415,487
  • Los Angeles: $414,925

 Metro areas that pay the lowest salaries:

  • Baltimore: $330,917
  • Providence: $346,092
  • San Antonio: $355,439
  • Washington DC: $356,633
  • Boston: $363,545
  • Portland: $363,890
  • Denver: $364,927
  • Philadelphia: $373,765
  • Birmingham: $375,074
  • Detroit: $376,007

Los Angeles is the biggest metro area to join the highest-paying list this year. On the lower end of salaries, several cities saw significant pay increases, like Detroit and San Antonio, which was at the bottom of the list on our 2022 report. All higher-paying metro areas are over $400,000 a year in salary.

Lower-paying metro areas tend to have older healthcare infrastructures and declining populations. However, there are a few exceptions, including Denver, which is a younger, growing city. Eastern seaboard cities and some Southern cities continue to pay lower salaries and are losing population in favor of higher pay and improved housing costs in growing mid-sized cities in Florida, some parts of Texas, and the Midwest.

top-ten-states-high-median-salaries

*Indicates states that are new to the top ten for 2023.

Oregon, North Carolina, Connecticut, and Texas join the Top Ten highest median salary states for 2023. Iowa, South Carolina, Oklahoma, and Georgia are no longer in the Top Ten.

For physicians in four high-paying specialties, median salaries vary significantly, depending on the region in which they work:

Physician salary by region

Median salaries in these specialties are beginning to show significant variations between specialty and regionally. However, East coast salaries continue to be lower on average than those in other regions.

There are a variety of reasons for this variation in pay, and higher concentrations of qualified physicians in the Eastern region continue to be a significant influence on median annual earnings for many specialties.

Compensation by Specialty

PCPs earned an average of $251k in 2022, a 3% increase over 2021—the highest historical average recorded to date. Grouped together, specialists earned an average of $351k in 2022, up from $344k in 2021.

Surgical specialists continue to be among some of the highest-paid professionals in medicine. Pediatricians and those who practice family medicine continue to be among the lowest-paid physicians.

Median salary by physician specialty

Specialties with the biggest salary increases:

  • Ob/GYN +14%
  • Radiology +12%
  • Anesthesiology +8%
  • Cardiology +8%
  • Neurology +7%

Specialties with the biggest salary decreases:

  • Cardiology (Inv) -16%
  • Dermatology -3%
  • Pediatrics -3%
  • Nonsurgical specialists-1%
  • Surgical physicians-1%

Plastic surgeons, cardiologists and orthopedic surgeons remain among the highest-earning specialties with an average compensation over $500,000. 

Compensation by Gender

Female physician compensation data

The pay gap between female and male physicians in the United States continued in 2022.

The overall gender pay gap between male and female physicians is significant. Current data shows that on average, male doctors earn $122,000 a year more than female counterparts. Analyzing the five medical specialties with the largest pay gaps between male and female practitioners, male specialists earned an average of $477,484 as compared to females in the same five specialties, who earned an average of $377,732, a difference of over 20%.

Pay does vary depending on location, so where do women earn the most and earn the least? Hartford, CT appeared on the lowest-paying list in 2021 and rose to the highest-paying in 2022.

Where is the gender wage the most prevalent?

Our findings illustrate that the gender pay gap varies considerably based on region and specialty.

Specialties with the largest gender wage gaps:

  • Oral/Maxiollofacial Surgery: women earn 22.8% less
  • Allergy & Immunology: women earn 21.1% less
  • Otolaryngology: women earn 20.1% less
  • Pediatric Nephrology: women earn 20% less
  • Thoracic Surgery: women earn 19.5% less

Specialties with the smallest gender wage gaps:

  • Pediatric Rheumatology: women earn 7.8% less
  • Pediatric Infectious Disease: women earn 10.1% less
  • Pediatric Hematology/Oncology: women earn 11.3% less
  • Hematology: women earn 12.1% less
  • Pediatric Cardiology: women earn 12.5% less

 

Top 10 Cities Where Female Physician Earn the Highest Annual Compensation

  • Minneapolis: $347,426
  • Sacramento: $3414107
  • Tampa: 339,505
  • Buffalo: $335,247
  • Charlotte: $331,556
  • Dallas: $331,215
  • San Francisco: $329,954
  • St. Louis: $329,971
  • Los Angeles: $328,223
  • Hartford: $327,996

 Bottom 9 cities Where Female Physicians Earn the Least Annual Compensation

  • San Antonio: $287,268
  • Detroit: $386,952
  • Washington, DC: $286,782
  • Richmond: $284,902
  • Memphis: $278,699
  • Brimingham: $278,488
  • Providence: $276,927
  • Louisville: $276,509
  • Baltimore: $262,109

Related: How Female Physicians can Counteract the Gender Pay Gap

Compensation Bonuses

Physicians in both primary care and specialties continue to earn bonuses, and after a decline in 2021, RVU-based bonuses once again represent a major source of bonuses for physicians.

Bonuses for Quality of Care increased from 23% to 58% between 2021 and 2022.

Types of physician bonuses

In 2022, here’s how bonuses compared to the previous year:

  • RVU-based: 70% (up from 57% last year)
  • Quality of Care: 26% (up from 23% last year)
  • Net Collections: 18% (down from 23% last year)
  • Patient encounters: 9% (down from 10% last year)
  • Gross Billings: 3% (up from 2% last year)

Top 17 Average Incentive Bonuses by Specialty:

  • Orthopedics/Orthopedic surgery: $126k
  • Ophthalmology: $100k
  • Cardiology: $85k
  • Gastroenterology: $74k
  • Urology: $73k
  • Anesthesiology: $68k
  • Radiology: $66k
  • Pathology: $54k
  • Emergency Medicine: $54k
  • OB/GYN: $49k
  • Physical Med/Rehab: $48k
  • General Surgery: $46k
  • Psychiatry: $33k
  • Family Medicine: $30k
  • Internal Medicine: $29k
  • Neurology: $29k
  • Pediatrics: $28k

For the first time in the past decade, every specialty reported receiving some form of incentive bonus. On an individual basis, 57% of specialists reported earning an incentive bonus in 2022. Amongst PCPs, 54% received an average incentive bonus of $33.5k.

Related: When Physicians Should Walk Away From a Job Offer

Compensation Trends Summary

Here are some key takeaways:

  • Primary care physicians earned an average of $260,000 in 2022, up from $242,000 in 2021.
  • Specialists earned an average of $368,000 in 2022, up from $344,000 in 2021.
  • Depending on the specialty, physicians in the West and Midwest earn the highest salaries; however, for most specialties and PCPs, salaries in the East are the lowest.
  • Plastic surgery and orthopedics #1 and #2 on annual compensation surverys, each earning over $500,000 per year, closely followed by cardiology, averaging $490,000 per year
  • The biggest salary increases in 2022 were otolaryngology (up 13%), gastroenterology (up 12%), and dermatology (up 11%).
  • Pediatrics is among the lower-paid specialties, but saw a 10% increase in pay on average in 2022. Ophthalmology and plastic surgery saw 10% salary increases as well.
  • The biggest salary decreases are in cardiology and dermatology.
  • On average, female physicians earn 23.6% less than male physicians in the same specialty.
  • 57% of specialists earned an incentive bonus.
  • 54% of PCPs earned an incentive bonus.

Hiring Trends

Hiring trends can change rapidly depending on regional and local needs. Rapid change in the healthcare system also creates demand for different specialties in different regions.

We use data from medical recruiting firms and annual surveys to create a breakdown of hiring trends based on specialty, region and medical setting.

Hiring Trends by Specialty

Between 2007 and 2019, family physicians were the most heavily recruited physicians around the country. In 2022, Nurse Practitioners became the most-requested hiring category. The COVID-19 pandemic and changing demographics are giving rise to the third consecutive year that specialists were the most-requested and recruited hiring category.

Top 10 Most Recruited Physicians:

  • Gastroenterologists
  • Radiologists
  • Rheumatologists
  • Hematologist/Oncologists
  • Urologists
  • Cardiologists
  • Pulmonary/Critical Care
  • Psychiatrists
  • OB/GYNs
  • Neurologists

There are five specialties which generate up to seven times their salary for average net annual hospital revenue: cardiology, orthopedic surgery, gastroenterology, family medicine, and OB/GYN.

Continued focus on mental health and post-pandemic stress saw psychiatrists remaining on the most in-demand list.

The physician shortage is ongoing and is expected to continue for the next decade.

Projected deficit of physicians through 2034:

  • Primary Care: 17,800-48,000
  • Medical Specialists: 16,8080
  • Surgery: 13,900
  • Other (including NPs): 26,400
  • Hospitalists: 1,900

The physician shortage continues, along with shortages in specific specialties and allied practitioners.

By 2034, the overall shortage of physicians in the United States could reach 124,000. Of that, approximately 48,000 are primary care physicians and 76,000 will be specialists, ssurgeons, or hospitalists.

Hiring Trends by Region

The Eastern region and most large metro areas throughout the nation have the greatest number of trained physicians. Midwestern and Southern states, along with rural areas, are confronting large aging populations and have a greater shortage of trained practitioners. Hiring surveys show that areas with a shortage of physicians continue to offer higher salaries and larger bonuses to attract qualified candidates.

Shifts in care models are also affecting recruitment and hiring, including an increase in academic medical center recruitment and a move toward convenient care and telemedicine. Here’s how recruitment trends have changed, based on employment setting, over the past year:

  • Hospital recruitment: 34% in 2022 (up from 33% in 2021)
  • Medical group recruitment: 18% in 2022 (down from 29% in 2021)
  • Academic medical center recruitment: 34% in 2022 (up from 20% in 2021)
  • Federally qualified health center recruitment: 8% in 2022 (unchanged from 8% in 2021)
  • Physician recruitment for solo, partnership, and concierge practices: 31% in 2022 (down from 3% in 2021)

Regardless of specialty, some employment settings offer higher salaries than others. Here’s how the average salary varies by employment setting for some of the top-earning specialties:

Orthopedic Surgery (General)

  • Single specialty: $650k
  • Multi-specialty: $663k
  • Rural Health Clinic: $603k
  • FHospital Department Practice: $675k
  • Academic Department: $400k

Cardiology (Invasive-Interventional)

  • Single specialty: $627k
  • Multi-specialty: $601k
  • Rural Health Clinic:$656k
  • Hospital Department Practice: $626k
  • Academic Department: $425k

Urology

  • Single specialty: $525k
  • Multi-specialty: $521k
  • Rural Health Clinic:$475k
  • Hospital Department Practice: $506k
  • Academic Department: $400k

The biggest factors causing physician shortages:

  • An aging population: the number of people 65 and older is expected to grow by 42% between now and 2034.
  • Retirements: more than two out of five current physicians will be over age 65 between now and 2034.
  • Burnout, stress, and COVID-19 effects are also expected to have an impact on physician shortages.
  • Regional and geographic impacts are expected to continue in areas with more aging adults (Midwest and South).
  • Telehealth and convenient care are influencing hiring trends and work conditions.

In 2021, some recruits did not receive relocation benefits that were standard before the pandemic, but some benefits were restored in 2022, along with decreases in most benefit packages.

In 2020/2021, 74% of new offers included relocation expenses, increasing to 78% in 2021/2022.

CME offers remained relatively stable, with 92% of new offers receiving CME payments this year, down from 94% last year.

Other benefits are down across the board for new hires:

    • Health insurance: 68% (down from 78% last year)
    • Malpractice: 66% (down from 78% last year)
    • Retirement/401k: 61% (down from 68% last year)
    • Disability: 61% (down from 70% last year)
    • Educational Forgiveness: 16% (down from 21% last year)

Hiring Trends Summary

Here are the key takeaways:

    • We are continuting to see a shortage of physicians, particularly in the Midwest and Southern regions. This is not expected to change.
    • Demand for physicians is expected to increase, some specialties more than others.
    • Underserved and Rural areas pay the highest salaries as well as the biggest bonuses.
    • Family Physicians, which used to be in the highest demans, have not been the most recruited physicians since 2020.

Ongoing Impacts of COVID-19 and Other Trends

COVID-19 continues to impact the healthcare industry. Trends like telemedicine and “convenient care” affect work along with issues like burnout & stress.

Overall, salary trends for all physicians are up, including primary care physicians and specialists. However, among physicians who saw a decrease in income, 70% said that they continued to experience effects of the COVID-19 pandemic, including reductions in hours or job loss. 44% of physicians who lost income in 2022 credited another factor, including telehealth provided by insurance companies and convenient care at “minute clinics.”

Covid Effects in 2022:

As a result of COVID-19, in 2021, 72% of physicians reported a reduction in income, 43% had to work with reduced staff, and 8% closed their practices. By 2022, hiring had increased and long-term health challenges and the aging population drove rehiring and increased income:

  • 15% experienced a reduction in income, down from 72% in 2021
  • 8% have had to work with reduced staff
  • 8% have had to close their practice; largely a result of retirement

The pandemic has taken a serious toll on physicians’ lives outside of work as well. Physicians report experiencing the following:

  • Burnout: 58%
  • Feelings of anger and/or anxiety: 50%
  • Withdrawing from family and friends: 43%
  • Sought medical attention for a mental health issue: 13%

Covid Continues to Affect Life Outside of Work:

Physicians report heavier workloads along with the following impacts:

  • Burnout: 68%
  • Feelings of anger and/or anxiety: 53%
  • Withdrawing from family and friends: 35%
  • Sought medical attention for a mental health issue: 17%

More than 38% of physicians surveyed have also expressed a desire to retire in the next year.

Would Physicians Choose the Same Specialty Again?

If given the chance to change careers, 73% of physicians said they would choose to work in medicine again. Of those, the majority of specialists are satisfied with their choice of specialty, although some are more satisfied than others.

Physicians Most Likely to Choose the Same Specialty Again:

  • Dermatology: 99%
  • Orthopedics: 97%
  • Plastic Surgery: 96%
  • Gastroenterology: 95%
  • Infectious Disease: 94%
  • Ophthalmology: 94%
  • Radiology: 92%
  • Urology: 90%

Physicians Least Likely to Choose the Same Specialty Again

    • Pulmonary Medicine: 79%
    • Public Health/Preventative Medicine: 79%
    • OB/GYN: 76%
    • Emergency Medicine: 74%
    • Nephrology: 73%
    • Family Medicine: 68%
    • Internal Medicine: 63%

How Many Hours Are Physicians Working?

Physicians are working approximately the same number of hours now as they were prior to COVID-19, an average of 50 hours per week. Slightly more than 20% of physicians work 40 to 49 hours a week, about 25% work between 50 and 59 hours a week, and over 30% work more than 60 hours a week.

Time Spent on Patient Care versus Paperwork:

Physicians are spending an average of 15.48 hours per week on paperwork and administration. Different specialties are required to spend more time on paperwork than others.

Infectious disease specialists spend 19.8 hours a week on paperwork and administration, while anesthesiologists spend 10 hours a week.

Specialties like endocrinology, rheumatology, and OB/GYN average 15 hours per week on paperwork.


Are Physicians Happy?

Many physicians feel that their work is rewarding and their salary is fair. But how happy are physicians on the job?

Data shows that significant numbers of physicians don’t feel as though they are being fairly compensated and that they are dissatisfied with a variety of work conditions. However, the rewards of helping patients and discovering answers continue to provide happiness and satisfaction.

Aspects of the job that physicians find the most rewarding:

  • Gratitude/relationships with patients: 27%
  • Finding answers/making diagnoses: 25%
  • Helping others: 23%
  • Earning the salary: 12%
  • Making good money at a job I like: 10%
  • Being proud to be a physician: 5%
  • Teaching: 5%
  • Nothing: 3%
  • Other: 2%

Aspects of the job that physicians like the least:

  • Having so many rules and regulations: 23%
  • Working long hours: 15%
  • Difficult patients: 15%
  • Difficulty getting reimbursement: 12%
  • Working on an EHR system: 12%
  • Other: 10%
  • Worrying about being sued: 7%
  • Danger/risk of treating COVID-19 patients: 3%
  • Nothing: 3%

Physician compensation chart

Specialties with the Greatest Amount of Physicians Who Feel Their Compensation is Fair:

  • Public Health & Preventative Medicine: 72%
  • Oncology: 67%
  • Plastic Surgery: 66%
  • Psychiatry: 65%
  • Radiology: 63%
  • Otolaryngology: 63%
  • Pulmonary Medicine: 61%

Specialties Who Do NOT Believe They are Fairly Compensated:

  • OB/GYN: 49%
  • Internal Medicine: 49%
  • Physical Med & Rehab: 49%
  • Pediatrics: 47%
  • Diabetes & Endocrinology: 46%
  • Nephrology: 42%

Many physicians are satisfied with their work and compensation, but medicine is challenging and a number of physicians are experiencing burnout and stress.

Physicians continue to work long hours, and industry change is ongoing. Many physicians are asked to work with difficult-to-use and time-consuming EHR systems and cope with staff shortages. Physicians can discover their options and work with professionals to obtain the compensation they want and sign contracts that can improve their job satisfaction.

About to sign a physician contract for the first time? Conducting a job search in a new state? Wondering how your incentives and bonuses stack up against other physicians in your specialty or others?

This report shows the current landscape of compensation and hiring trends to help physicians gather industry data and analyze their potential, no matter where they are in their careers.

Figures provided are averages and can change. To understand your market value for your specialty and region, talk with one of our expert contract review specialists. We can help you negotiate the compensation you deserve.

To hire a contract review specialist, discuss financial planning for retirement, find creative tax-saving solutions, or protect your finances with disability insurance or life insurance, contact Physicians Thrive now.

SOURCES FOR THIS REPORT INCLUDE:

Free Compensation Review

THE 2022 PHYSICIAN COMPENSATION REPORT

Regardless of your specialty or what city you work in, most physicians are curious about how their salary stacks up against the competition.

Whether you’re thinking about practicing in a new state or wondering if your signing bonus is on par with what it should be, know the facts to protect yourself and your annual earnings.

Let’s answer some questions about:

  • Which physicians make the most money?
  • Moving a few states away to increase your salary?
  • How your specialty compares against the salaries of physicians in other areas of medicine?
  • How much physicians are really making
  • Which specialties are in the greatest demand
  • Which regions of the country are hiring the most
  • Where physicians are being offered the biggest bonuses

Spending hours pouring through hundreds of pages in pricey compensation reports is usually the only way to find this information — but we did the legwork for you.

We have created our annual physician compensation report to save you both time and money looking for the data and statistics you want to know.

In this report, we detail:

  • How physicians in different medical specialties and regions of the United States are being compensated for their work
  • The gender wage gap
  • How much physicians are earning in bonuses and incentives
  • Which specialties are in the greatest demand

We’ve compiled data from nearly a dozen different sources from data made available as of 2021 to offer you:

Compensation by Region

Large and mid-sized metro areas, where there are more medical institutions and more medical professionals, continue to pay some of the lowest salaries.

Rural areas, which tend to have a more difficult time recruiting top-tier talent, continue to pay some of the highest salaries in the country.

There are, however, some mid-sized metro areas that saw a salary increase. Five of the ten are located in the Southeast region of the U.S.

Metro areas with the biggest salary increases:

  • Providence +8.9%
  • Portland, OR +8.6%
  • Richmond, VA +7.5%
  • Las Vegas +7.2%
  • New Orleans +7.2%
  • Birmingham +6.9%
  • Atlanta +6.8%
  • Denver +6.7%
  • Salt Lake City +6.5%
  • Jacksonville +6.3%

 Metro areas that pay the highest salaries:

  • Milwaukee: $430,274
  • Atlanta: $428,244
  • Jacksonville: $427,090
  • Buffalo: $407,070
  • Orlando: $406,587
  • Raleigh: $406,365
  • Charlotte: $404,285
  • Minneapolis: $401,978
  • Riverside, CA: $397,005
  • Dallas: $396,184

 Metro areas that pay the lowest salaries:

  • San Antonio: $329,475
  • Virginia Beach: $331,952
  • Boston: $347,894
  • Baltimore: $348,389
  • Washington D.C: $351,272
  • Denver: $352,073
  • Philadelphia: $354,788
  • Memphis: $356,875
  • Louisville: $360,609
  • Providence: $365,807

In addition to having more medical professionals overall, the metro areas paying the smallest salaries have a few other things in common.

Many of them have older healthcare infrastructures as well as plateauing populations. This is especially the case with cities on the eastern seaboard, such as D.C., Baltimore, Philadelphia, and Boston, as large groups of people are moving out of these more expensive cities in favor of more affordable cities in the South and Midwest.

top-ten-states-high-median-salaries-p5-

*Indicates states that are new to the top ten for 2020. These states replaced Utah, Ohio, and North Carolina.

Physicians in rural areas are earning higher salaries than those in metropolitan areas. Data shows that physicians across the highest-paying specialties are earning more in rural regions:

Physician salary by region

Overall, the Midwest and the South make the most, while physicians on the East and West coasts earn the least. There are a variety of reasons for this variation in pay, with the higher concentration of qualified physicians in the Northeast region continuing to be one of the most significant.

PCPs earned an average of $242k in 2021, down slightly from $243k in 2020. Specialists earned an average of $344k in 2021, down from $346k in 2020.Surgical specialists continue to be among some of the highest-paid professionals in medicine. Pediatricians and those who practice family medicine continue to be among the lowest-paid physicians.

Median salary by physician specialty

Specialties with the biggest salary increases:

  • Plastic Surgery +10%
  • Oncology +7%
  • Rheumatology +5%
  • Cardiology +5%
  • Diabetes and Endocrinology +4%

Specialties with the biggest salary decreases:

  • Allergy/Immunology -9%
  • Otolaryngology -9%
  • Anesthesiology -5%
  • Pediatrics -5%
  • Dermatology -4%

Plastic surgeons and orthopedic surgeons are the highest earners and are the only specialties with an average compensation of over $500,000. 

PCPs earned an average of $242k in 2021, down slightly from $243k in 2020. Specialists earned an average of $344k in 2021, down from $346k in 2020.Surgical specialists continue to be among some of the highest-paid professionals in medicine. Pediatricians and those who practice family medicine continue to be among the lowest-paid physicians.

Median salary by physician specialty

Specialties with the biggest salary increases:

  • Plastic Surgery +10%
  • Oncology +7%
  • Rheumatology +5%
  • Cardiology +5%
  • Diabetes and Endocrinology +4%

Specialties with the biggest salary decreases:

  • Allergy/Immunology -9%
  • Otolaryngology -9%
  • Anesthesiology -5%
  • Pediatrics -5%
  • Dermatology -4%

Plastic surgeons and orthopedic surgeons are the highest earners and are the only specialties with an average compensation of over $500,000. 

Compensation by Gender

Female physician compensation data

As in most professions, there continues to be a pay gap based solely on gender in the U.S.

Data shows that in primary care, men earn $269k per year, while women earn just $211k, approximately 22% less than their male counterparts. The gap is slightly larger in specialty medicine, with male specialists earning $376k per year and women specialists earning $283k (a difference of approximately 25%).

So, where do women earn the most and earn the least? Where is the gender wage gap most prevalent?
Our findings show that the gender pay gap varies considerably based on region and specialty.

Specialties with the largest gender wage gaps:

  • Otolaryngology: women earn 22% less
  • Geriatrics: women earn 21.4% less
  • Orthopedic surgery: women earn 20% less
  • Research: women earn 19.8% less
  • OBGYN: women earn 19.6% less

Specialties with the smallest gender wage gaps:

  • Nuclear medicine: women earn 2.5% less
  • Hematology: women earn 11.4% less
  • Urology: women earn 12% less
  • Colon/Rectal surgery: women earn 12.2% less
  • Emergency medicine: women earn 12.6% less

 

Related: How Female Physicians can Counteract the Gender Pay Gap

Compensation Bonuses

Physicians in both primary care and specialties continue to earn bonuses, but there has been a shift away from RVU-based production bonuses in favor of net collections bonuses.

There was also a large decrease in the quality-based bonus system.

Types of physician bonuses

In 2021, here’s how bonuses compared to the previous year:

  • RVU-based: 57% (down from 73% last year)
  • Net collections: 23% (up from 13% last year)
  • Gross billings: 2% (same as last year)
  • Patient encounters: 10% (down from 12% last year)
  • Quality: 23% (down from 64% last year)

Average incentive bonus by specialty:

  • Orthopedics/Orthopedic surgery: $116k
  • Ophthalmology: $87k
  • Otolaryngology: $72k
  • Urology: $72k
  • Cardiology: $71k
  • Radiology: $69k
  • Gastroenterology: $60k
  • Anesthesiology: $55k
  • OBGYN: $48k
  • General surgery: $47k
  • Emergency medicine: $44k
  • Pathology: $42k
  • Critical care unit physician: $41k
  • Neurology: $39k
  • Physical medicine/rehab: $37k
  • Family medicine: $27k
  • Internal medicine: $26k
  • Pediatrics: $26k
  • Psychiatry: $24k

Amongst specialists, 55% reported earning an incentive bonus in 2021. Amongst PCPs, 59% received an average incentive bonus of $27k.

Since the beginning of the COVID-19 pandemic, certain types of practices and employment settings have seen more growth than others, with multi-specialty group practices experiencing the most growth, and government settings seeing the least:

  • Multi-specialty group: 4.1%
  • Health maintenance organization: 3.9%
  • Industry/pharmaceutical: 3.8%
  • Health system/IDN/ACO: 2.7%
  • Single specialty group: 2.3%
  • Urgent care center/chain: 2.1%
  • Solo practice: 1.6%
  • Academic: 1.2%
  • Hospital: 1.1%
  • Government: 0.6%

Related: When Physicians Should Walk Away From a Job Offer

Compensation Trends Summary

Here are the key takeaways:

  • Primary care physicians earned an average of $242k in 2021, down from $243k in 2020.
  • Specialists earned an average of $344k in 2021, down from $346k in 2020.
  • Physicians in the Midwest earn the highest salaries; physicians in the East earn the least.
  • Plastic surgery, orthopedics, and orthopedic surgery, and cardiology are the three highest-earning specialties.
  • The biggest salary increases are in plastic surgery and oncology.
  • The biggest salary decreases are in allergy/immunology and otolaryngology.
  • On average, female physicians earn 25% less than male physicians in the same specialty.
  • 55% of specialists earned an incentive bonus.
  • 59% of PCPs earned an incentive bonus.
  • Multi-specialty group practices saw the biggest growth of any practice setting, at 4.1%.

Hiring Trends

Certain types of physicians are in much greater demand than others. In addition, certain regions are in much greater need of top-quality physicians.

We’ve compiled data from medical recruiting firms and other sources to create a breakdown of hiring trends based on specialty, region, and medical setting.

Hiring Trends by Specialty

For the past 13 years, family physicians have been the most heavily recruited physicians around the country. But with COVID-19 causing a decrease in office visits, 2021 created an increase in specialist recruiting for the first time in over a decade.

Top 10 Most Recruited Physicians:

  • Hematologists/Oncologists
  • Radiologists
  • Neurologists
  • Gastroenterologists
  • Psychiatrists
  • Dermatologists
  • Endocrinologists
  • Cardiologists
  • Family Medicine Specialists
  • Obstetricians/Gynecologists

Many of these specialties top the recruitment list because they generated some of the highest amounts of revenue for hospitals and practices.

With a focus on mental health and the stress caused to so many by the pandemic, psychiatry saw the fourth-highest engagement of any medical specialty this year.

There is still a continuing shortage of physicians across the board and a projected shortage throughout the next decade.

Projected deficit of physicians through 2025:

  • Cardiology: 7,080
  • Ophthalmology: 6,180
  • Orthopedic surgery: 5,050
  • Urology: 3,630
  • General surgery: 2,970
  • Cardiothoracic surgery: 1,800
  • Gastroenterology: 1,630
  • Hematology/oncology: 1,400
  • Pulmonology: 1,400
  • Neurological surgery: 1,200

There is also a growing shortage of physicians, nurse practitioners (NPs), and physician assistants (PAs) across the country.

By 2030, the overall shortage of physicians in the United States is expected to reach 121,300. Of that 121,300, approximately 55,200 are primary care physicians and 67,000 are specialists, spread out among a wide variety of specialties.

Hiring Trends by Region

The Eastern part of the country and most major metropolitan areas have the greatest number of trained physicians. Midwestern and Southern states, which have the largest aging populations, continue to face the most significant shortages. This directly corresponds to why physicians in these states often receive higher salaries and larger bonuses.

The pandemic continues to affect the growth of medical practices. Here’s how recruitment trends have shifted, based on employment setting, in the past year:

  • Hospital recruitment: 33% in 2021 (up from 26% in 2020)
  • Medical group recruitment: 29% in 2021 (up from 28% in 2020)
  • Academic medical center recruitment: 20% in 2021 (up from 18% in 2020)
  • Federally qualified health center recruitment: 8% in 2021 (up from 6% in 2020)
  • Physician recruitment for solo, partnership, and concierge practices remained unchanged at 3% in 2021 and 2020.

Some employment settings also prove riskier in terms of average salary. Here’s how the average salary varies by employment setting for some of the top-earning specialists:

Orthopedic Surgery (General)

  • Single specialty: $535k
  • Multi-specialty: $480k
  • Rural Health Clinic: $600k
  • Federally Qualified Health Center: $521k
  • Academic Department: $364k

Cardiology (Invasive-Interventional)

  • Single specialty: $550k
  • Multi-specialty: $435k
  • Hospital Department Practice: $450k
  • Rural Health Clinic:$520k
  • Academic Department: $236k

Urology

  • Single specialty: $305k
  • Multi-specialty: $419k
  • Hospital Department Practice: $400k
  • Federally Qualified Health Center: $406k
  • Academic Department: $281k

The biggest factors causing physician shortages:

  • Aging population (population over age 65 expected to grow 48% by 2032)
  • Overall population growth (expected to grow 10% by 2032)
  • A large amount of older physicians nearing retirement age
  • Rural and low-income urban areas are expected to see the greatest shortage
  • States with aging populations, such as the Midwest and South, are also expected to see the greatest shortages

It’s important to note that new recruits are being denied some benefits that were standard before the pandemic.

In 2019/2020, 97% of all recruitment offers included relocation expenses. For 2020/2021, only 74% of new offers included relocation expenses.

CME offers remained relatively stable, with 94% of new offers receiving CME payments this year, down from 96% last year.

While relocation expenses have been scaled back, the following benefits are up across the board for new hires:

    • Health insurance: 78% (up from 67% last year)
    • Malpractice: 76% (up from 67% last year)
    • Retirement/401k: 68% (up from 63% last year)
    • Disability: 70% (up from 58% last year)

Hiring Trends Summary

Here are the key takeaways:

    • There is a shortage of physicians, particularly in the Midwest and Southern regions.
    • The demand for physicians is expected to increase.
    • Rural and underserved areas pay the highest salaries and the biggest bonuses.
    • For the first time in over a decade, family physicians are no longer the most recruited physicians.

The Impact of COVID-19 on Physicians Salaries and Satisfaction

COVID-19 has had significant impacts on the healthcare industry. While hospitals are crowded with patients, physicians outside of hospital settings have experienced major decreases in appointments.

Forty-four percent of physicians believe that the reduction in patient visits will continue even after COVID, and that they could continue to have up to 25% less visits than they did prior to the pandemic. Ten percent of physicians expect COVID to have an even greater impact, and believe they will see visits drop by 26% or more as compared to pre-COVID visits.

Forty-six percent of physicians are more optimistic and expect that patient volume will return to normal after the pandemic.

Physicians report having experienced the following situations in their workplace setting since the beginning of COVID-19:

  • 72% have experienced a reduction in income
  • 43% have had to work with reduced staff
  • 8% have had to close their practice

The pandemic has taken a serious toll on physicians’ lives outside of work as well. Physicians report experiencing the following:

  • Burnout: 58%
  • Feelings of anger and/or anxiety: 50%
  • Withdrawing from family and friends: 43%
  • Sought medical attention for a mental health issue: 13%

More than 33% of physicians surveyed have also expressed a desire to retire in the next year.

Would Physicians Choose the Same Specialty Again?

If given the chance to change careers, 78% of physicians said they would choose to work in medicine again. Of those, some specialists are more satisfied with their choice of specialty than others.

Physicians most likely to choose the same specialty again:

  • Dermatology: 96%
  • Orthopedics/Orthopedic Surgery: 96%
  • Oncology: 96%
  • Ophthalmology: 94%
  • Otolaryngology: 93%
  • Radiology: 93%
  • Gastroenterology: 93%
  • Urology: 92%
  • Plastic Surgery: 92%
  • Cardiology: 92%

Physicians Least Likely to Choose the Same Specialty Again

    • Public Health/Preventative Medicine: 67%
    • Internal Medicine: 68%
    • Family Medicine: 71%
    • OBGYN: 74%
    • Nephrology: 77%
    • Critical Care Unit Physician: 78%
    • Emergency Medicine: 79%
    • Diabetes/Endocrinology: 81%
    • Pediatrics: 82%
    • Pulmonary Medicine: 83%

How Many Hours Are Physicians Working?

Physicians are working almost the same amount of hours now as they were prior to COVID-19. Many physicians were furloughed, and there was a reduction in patient volume, but most physicians report that they are working an average of 51 hours per week, up from 50 hours per week prior to COVID-19.

The breakdown of how many hours physicians spend on patient care versus paperwork varies significantly depending on specialty. Physicians in the infectious diseases field spend 24.2 hours per week on paperwork alone, and those in public health/preventative medicine spend 20.7 hours per week.

Ophthalmologists and anesthesiologists spend the least amount of time on paperwork, averaging just over 10 hours per week.


Are Physicians Happy?

For many physicians, the work is rewarding and their salary is fair. But are physicians actually happy with their job?  Data shows that many physicians don’t feel as though they are being fairly compensated and that they are dissatisfied with many aspects of the job.

Aspects of the job that physicians find the most rewarding:

  • Helping others: 26%
  • Relationships with patients: 26%
  • Finding answers, diagnoses: 24%
  • Earning the salary: 12%
  • Being proud to be a physician: 5%
  • Teaching: 4%
  • Other: 2%
  • Nothing: 2%

Aspects of the job that physicians like the least:

  • Having so many rules and regulations: 23%
  • Working long hours: 14%
  • Difficult patients: 14%
  • Difficulty getting reimbursement: 12%
  • Working on an EHR system: 11%
  • Worrying about being sued: 7%
  • Danger/risk of treating COVID-19 patients: 7%
  • Other: 9%
  • Nothing: 3%

Physician compensation chart

While many physicians are satisfied with their professions and their salaries, burnout is still common in the medical profession.

In addition to the stress that COVID-19 has put on the healthcare system, long hours, dealing with the bureaucracy of hospital administrations, and working on primitive electronic health records (EHR) systems remain some of the main contributors to their dissatisfaction.


 

 

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This report shows a broad picture of compensation and hiring trends to help physicians gather industry data and analyze the current healthcare landscape, no matter where they are in their careers.

Note that these are averages and are not set in stone. To understand your market value for your specialty and region, talk with one of our expert contract review specialists. We can help you negotiate the salary and incentives you deserve.

To hire a contract review specialist, discuss financial planning for retirement, find creative tax-saving solutions, or protect your finances with disability insurance or life insurance, contact Physicians Thrive now.

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