Physicians’ Compensation Report 2020
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.
Are you interested in:
- 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?
We wanted to know:
- 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 first 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 to offer you:
The Free Physicians Thrive 2020 Physicians’ 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, increases in salary for certain specialties, and increasing bonuses in areas where the demand for physicians is the highest.
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
The Midwest, the Great Plains, and the Southwest have seen the greatest uptick in salary increases, based primarily on the growing need for physicians in those regions. Population growth is a key factor, as is the fact that recruiters are working hard to staff top-tier talent in these areas.
In addition, there are some major metropolitan areas with high population growth rates that are seeing increased salaries as well.
Regions with the biggest salary increases:
- Seattle +15%
- Hartford +13%
- Riverside +12%
- Cincinnati + 12%
- Baltimore + 10%
- Bridgeport +9%
- Rochester +9%
- Ann Arbor +9%
- Washington +8%
- Atlanta +8%
Regions with the biggest salary decreases:
- San Antonio -10%
- Tampa -10%
- Virginia Beach -7%
- Louisville -6%
- Miami -5%
- Indianapolis -4%
- San Jose -4%
- Detroit -4%
- Charlotte -4%
Top ten states with the highest median average salary for physicians:
- Kentucky: $346k
- Tennessee: $338k
- Florida: $333k
- Alabama: $332k
- Utah* $328k
- Ohio* $326k
- Oklahoma $326k
- Indiana $326k
- North Carolina* $325k
- Georgia $323k
*Indicates states that are new to the top ten for 2020. These states replaced Arkansas, Connecticut, and Nevada.
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:[JH3]
|Orthopedic Surgery: General||$400,000||$558,450||$497,517||$529,000|
Overall, the Midwest, Great Plains, Southeast, and Southwest are seeing the biggest salary increases, whereas salaries in the Northeast are seeing smaller increases. There are a variety of factors for this, the most significant one being that there is a higher concentration of qualified physicians in the Northeast region.
Compensation by Specialty
Surgical specialists continue to be among the highest-paid professionals within medicine. Pediatricians and those who practice family medicine continue to be among the lowest paid physicians.
Median Average Salary by Specialty, Ranked Highest to Lowest:
Median Average Salary
|Pediatric Critical Care||$264,500|
|Child and Adolescent Psychiatry||$231,000|
Specialties with the biggest salary increases:
- Public Health and Preventative Medicine +11%
- Allergy & Immunology +9%
- Orthopedics +6%
- Oncology +5%
- Neurology +5%
Specialties with the biggest salary decreases:
- Family physicians -8.3%
- Dermatology -2%
- OB/GYN -1.9%
- Otolaryngology -1%
Neurosurgeons and cardiovascular surgeons continue to be the highest earners and are the only specialties with an average median salary of over $600,000.
Neurosurgeons in the Midwest are the highest paid of any specialist in any region of the country, with an average salary of $760,000 per year. Cardiovascular surgeons in the Western region of the country earn the most in their field, with an average salary of $650,000 per year.
Compensation by Gender
As in most professions, there is a pay gap based solely on gender in the U.S.
As of 2017, the wage gap was 27.7%, meaning that women earned nearly 28% less than their male counterparts in the same field. As of 2018, that number decreased to 25.2%. The pay gap between women and men is narrowing slightly, but women are still earning far less than men working in the same specialty, region, and field.
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.
Top 10 cities where female physicians earn the highest annual compensation:
- Milwaukee, WI $351,247
- Bridgeport, CT $319,577
- Seattle, WA $306,310
- Minneapolis, MN $303,416
- Riverside, CA $302,937
- Orlando, FL $301,789
- Jacksonville, FL $296,143
- Charleston, SC $295,874
- Los Angeles, CA $290,569
- Birmingham, AL $288,663
Top 10 cities where female physicians earn the least annual compensation:
- Providence, RI $220,482
- Durham, NC $226,594
- Louisville, KY $230,574
- Virginia Beach, VA $232,172
- Austin, TX $232,333
- San Antonio, TX $239,680
- Las Vegas, NV $241,268
- Chicago, IL $248, 925
- New Haven, CT $249,508
- Miami, FL $253,411
Regions with the highest gender wage gaps:
- Louisville, KY/Jefferson County, IN: women earn 40% less
- New Orleans, LA: women earn 32% less
- Austin, TX: women earn 31% less
- Hartford, CT: women earn 31% less
- Dallas, TX: women earn 31% less
Regions with the smallest gender wage gaps:
- Birmingham, AL: women earn 9% less
- Bridgeport, CT: women earn 10% less
- Seattle, WA: women earn 15% less
- Milwaukee, WI: women earn 14% less
- Jacksonville, FL: women earn 16% less
Specialties with the largest gender wage gaps:
- Pediatric pulmonology: women earn 23% less
- ENT: women earn 22% less
- Urology: women earn 22% less
- Radiology: women earn 21% less
- Pediatrics: women earn 20% less
Specialties with the smallest gender wage gaps:
- Hematology: women earn 4% less
- Rheumatology: women earn 8% less
- Radiation Oncology: women earn 9% less
- Thoracic Surgery: women earn 11% less
- Plastic Surgery: women earn 11% less
Overall, male primary care physicians earned an average of $264,000, while women in primary care earned just $212,000, approximately 25% less. The wage gap is even greater among specialists, with men earning an average of $385,000 and women earning just $286,000, approximately 30% less.
Physicians have enjoyed record-high bonuses in 2018 and 2019. These bonuses come in several forms, including signing bonuses and RVU productivity bonuses.
How physicians are earning bonuses:
- 70% of all physicians earned a signing bonus (down from 75% in 2017/2018)
- 70% of physicians earned RVU based bonuses (up from 50% in 2017/2018)
- 56% of physicians earned bonuses based on quality of care
- 18% of physicians earned bonuses based on net collections
- 9% of physicians earned bonuses based on patient encounters
- 3% of physicians earned bonuses based on gross billings
Average signing bonus by specialty:
- All physicians: $32,692 (down from $33,707 last year)
- Neurosurgeons: $47,500
- Orthopedic Surgeons: $40,000
- OB/GYNs: $30,115
- Internal Medicine: $29,308
- Radiology: $27,045
- Family Practice: $26,071
- Anesthesiologist: $25,650
- Cardiology Non-Invasive: $25,000
- Hematologist/Oncologist: $25,000
- Pulmonologist: $25,000
- Otolaryngologist: $23,425
- Psychiatry: $22,955
- Cardiology Invasive: $20,000
- Emergency Medicine: $20,000
- Dermatologist: $17,372
Top fifteen average incentive bonuses by specialty:
- All Physicians: $26k
- Orthopedics: $96k
- Otolaryngology: $91k
- Ophthalmology: $85k
- Radiology: $77k
- Urology: $64k
- Cardiology: $63k
- Gastroenterology: $63k
- Anesthesiology: $57k
- Nephrology: $50k
- Pathology: $46k
- OB/GYN: $44k
- Critical Care: $41k
- Surgery: $41k
- Emergency Medicine: $40k
- Neurology: $35k
Overall, 58% of all primary care physicians earned an incentive bonus, as compared to 55% of specialists. 70% of all physicians earned a signing bonus. Both signing bonuses and incentive bonuses vary based on region.
How Do Physicians Want to Be Paid?
Physicians earn their compensation in a number of ways, with the quality-based compensation model seeing the biggest increase. Others get paid on a wRVU model combined with other elements of the RVU.
Most physicians want salaries and bonuses:
- 70% of physicians prefer to be paid via a merit-based incentive program (salary plus production bonus)
- 56% of physicians prefer to be paid based on quality-based merits, such as patient satisfaction
- 30% of physicians prefer to be paid with a straight salary or salary + bonus with an income guarantee
30% of physicians want additional forms of compensation:
- Relocation compensation: average of $10,393 (up from $9,441 last year)
- CME: average of $3,620 (down from $3,888 last year)
- Loan repayment: 31% of physicians received (up from 18% last year)
- Loan forgiveness offered: average of $101,571 (up from $82,833 last year)
Overall, physicians aren’t just earning salaries anymore. They’re earning large bonuses as a part of their recruitment package as well as incentive-based bonuses tied to quality indicators.
Compensation Trends Summary
Here are the key takeaways:
- Primary care physicians earn an average of $243,000 per year, up from $237,000 in 2019
- Specialists in 2020 earn an average of $346,000 per year, up from $341,000 in 2019
- Physicians in the Midwest earn the highest salaries; physicians in the East earn the least
- Neurosurgeons, cardiovascular surgeons, and orthopedic surgeons are the three highest-earning specialties
- The biggest salary increase is in Public Health and Preventative Medicine
- The biggest salary decrease is in Family Medicine
- On average, female physicians earn 28% less than male physicians in the same specialty
- 70% of all physicians earned a signing bonus (average of $32,692)
- 55% of all specialists earned an incentive bonus (average of $26,000)
- 70% of all physicians prefer to be paid with a salary plus a quality-based incentive bonus
Certain types of physicians are in much greater demand than others. In addition, certain regions are in much greater need of top-quality physicians.
Hiring Trends by Specialty
Family physicians are by far the most heavily recruited physicians around the country. For the 13th year in a row, family physicians are being recruited hundreds at a time in large consolidated systems. Since 2014, the number of physicians choosing to work in family medicine has decreased, leaving family practices understaffed throughout the country.
Top 20 most recruited physicians:
- Family physicians
- Nurse practitioners
- Internal Medicine
- Emergency Medicine
- Orthopedic Surgery
- Nurse Anesthetists
Projected % overall increase in demand for physicians through 2028:
- All physicians: 7%
- Psychiatrists: 16%
- Family practitioners: 10%
- Surgeons: 8%
- Anesthesiologists: 4%
- Internists: 4%
- OB/GYNs: 2%
- Pediatricians: 2%
Overall, the need for physicians is expected to grow through 2028, with psychiatrists, surgeons, and family practitioners seeing the biggest percentage increase.
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 no shortage of trained physicians. Midwestern and Southern states are facing the greatest amount of shortages, which directly corresponds to why physicians in these states are often offered higher pay rates and larger bonuses.
States most likely to face a physician shortage:
States with the highest percentage of physicians nearing retirement age (age 60 or older):
- New Mexico: 37%
- Hawaii: 35.5%
- New Jersey: 35%
- Montana: 35%
- Maine: 34.6%
States least likely to face a physician shortage:
- Rhode Island
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 Florida and California, are also expected to see significant shortages over the next 10 years
Hiring Trends by Gender
More women are enrolled in medical school than ever before, and there are certain specialties where women are on pace to become the vast majority of physicians in their field.
In 2015, 46.9% of medical school students were female. That number rose to 49.5% in 2018 and 50.5% in 2019, making women the majority of all medical school students in the country.
Specialties with the greatest amount of female physicians:
- 73% of pediatric residents are women
- 80% of OB/GYN residents are women
Who is Hiring?
Where are physicians getting hired? Hospitals and hospital systems remain the main hiring source of physicians in the U.S., but there are other settings where physicians are in need.
Medical recruiters provide evidence that where physicians want to work is changing:
- 34% of physicians want to work in a hospital setting (down from 51% four years ago)
- 28% of physicians seek employment in medical groups (up from 21% two years ago)
- 56% of physicians want to work in a small setting with less than 10 employees (such as clinics owned by large medical groups)
- 9% of physicians prefer to work for federally qualified health centers (down 15% from two years ago)
- 20% of physicians want to work in academic settings (up from 8% in 2015)
- 1% of physicians prefer to work alone (down from 5% in 2015/2016)
How Are Physicians Getting Hired?
The vast majority of physicians are employed; they are not working in private practice. In 2001, 40% of physicians were employed. As of 2019, 90% of all physicians are employed.
Where physicians are in the greatest demand, they’re also getting substantial relocation bonuses as part of their incentive package to sign a contract with a new employer.
Average salary of employed physicians vs. self-employed physicians:
- Employed physicians: $297,000 per year
- Self-employed physicians: $357,000 per year
Specialties earning the highest relocation costs:
- Average all physicians: $10,393 (up from $9,441 last year)
- Pediatrics hematology/oncology: $15,385
- Psychiatry: $15,385
- Critical care physicians: $15,193
- Hematology/oncology: $15,000
- Internal medicine: $15,000
- Orthopedic surgery: $15,000
- General surgery: $15,000
Hiring Trends Summary
Here are the key takeaways:
- There is a shortage for physicians, particularly in the Midwest and Southern regions
- The demand for physicians is expected to increase by 7% through 2028
- Physicians are seeking employment in smaller medical settings as opposed to large hospital settings
- Large hospital groups are being forced to provide incentives such as signing bonuses, larger salaries, and relocation costs in order to recruit physicians
- Rural and underserved areas pay the highest salaries and the biggest bonuses
- Family physicians are the most recruited physicians
The Impact of COVID-19 on Physicians Salaries
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 patient visits.
Here a few statistics that demonstrate the impact of the COVID-19 pandemic on physicians:
- Physicians have seen a 55% decrease in revenue
- Physicians have seen a 60% decrease in patient volume
- Physicians in ophthalmology, dermatology, orthopedics, plastic surgery, and cardiology have seen the biggest decreases in patients
- 9% of all independent medical practices closed
- 43,000 healthcare workers were laid off between March 2020 and September 2020
- 85% of all medical settings hired locum tenens physicians
Another major impact that COVID-19 has had on healthcare is the increasing need for telehealth services. It remains to be seen what impact COVID-19 will have on physician salaries, but bonuses are increasingly being provided to physicians who offer telehealth services.
Participation in Patient Payment Methods
Physicians accept patient payments in a variety of different ways. The most popular payment method is still health insurance, though 26% of all physicians do not accept health insurance as a patient payment method.
How physicians accept payment from patients:
- Insurance: 74%
- Accountable care organizations*: $26%
- Direct primary care: 10%
- Cash-only: 5%
- Concierge: 2%
- Other: 10%
Accountable care organizations are on the decline. There were 561 in 2018. In 2019, there were only 517 ACOs.
How Are Claims Being Paid?
Are physicians actually collecting payments from their patients? Certain specialties have a high number of claims that get denied or need to be resubmitted.
Top 10 specialties with the highest % claims that are denied or need to be resubmitted:
- Plastic surgery: 28%
- Emergency medicine: 22%
- Radiology: 20%
- Critical care: 20%
- General surgery: 19%
- Physical medicine and rehabilitation: 19%
- Anesthesiology: 19%
- Orthopedics: 18%
- Pulmonary medicine: 18%
- Neurology: 18%
How Many Hours Are Physicians Working?
Physicians are working about the same amount of hours as in previous years, though how they spend their time is changing a bit.
Both primary care physicians and specialists work approximately 53.2 hours per week, up slightly from the 52.63 hours they reported working in 2016.
How physicians spend their time:
- 38 hours per week with patients
- 15.6 hours with on paperwork (up from 11.37 hours per week in 2018)
Physicians are driven to work more hours when incentive bonuses exist. 34% of primary care physicians and 32% of specialists say this is what drives them to work more hours.
How Do NPs and PAs Fit In?
There were more than 385,000 Nurse Practitioners and Physician Assistants working in hospitals and practices in 2019. Having NPs and PAs on staff is an effective way for practices and large health groups to maximize profits, particularly in a value-based system.
By having NPs and PAs on staff, physicians can devote more time to complicated, higher value procedures.
The facts about NPs and PAs:
- There are 265,000 NPs practicing today
- There are 120,000 PAs practicing today
- NPs and PAs handle as much as 80% of a physician’s duties
- 78% of NPs provide primary care
- 22% of NPs work in specialties
- 33% of PAs provide primary care
- 66% of PAs work in specialties
Nurse practitioners may be able to do the vast majority of work that a physician can do, but they certainly don’t make the same salary. The average median wage for an NP has decreased by approximately 3.8% since 2018.
Median average NP salary for the past five years:
- 2019: $124,000
- 2018: $129,000
- 2017: $123,000
- 2016: $117,000
- 2015: $107,000
The demand for both PAs and NPs is growing, but not all medical settings put them on staff. 47% of health settings say that having NPs and PAs has increased their profitability. 47% say it has no effect on their profitability, and 6% say it has actually decreased profits.
The percentage of medical settings that hire PAs and NPs:
- 36% of all medical settings use PAs
- 50% of all medical settings use NPs
- 38% don’t use either
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:
- Relationships with patients: 27%
- Finding answers, diagnoses: 24%
- Helping others: 23%
- Earning the salary: 12%
- Being proud to be a physician: 5%
- Teaching: 5%
- Other: 2%
- Nothing: 2%
Aspects of the job that physicians like the least:
- Having so many rules and regulations: 26%
- Working long hours: 15%
- Working on an EHR system: 15%
- Difficult patients: 14%
- Difficulty getting reimbursement: 12%
- Worrying about being sued: 7%
- Other: 9%
- Nothing: 2%
Specialties with the greatest amount of physicians who feel their compensation is fair:
- Oncology: 67%
- Emergency medicine: 67%
- Radiology: 67%
- Psychiatry: 66%
- Otolaryngology: 66%
- Public health and preventative medicine: 65%
- Dermatology: 65%
- Pathology: 62%
- Cardiology: 61%
- Anesthesiology: 60%
While many physicians are satisfied with their professions and their salaries, burnout is still common in the medical profession. Long hours, dealing with the bureaucracy of hospital administrations, and working on primitive Electronic Health Records systems are the main contributors to their dissatisfaction.
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 other specialties?
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 value as compared with the fair market value for your specialty and region, talk with one of our expert contract review specialists. Your salary and incentives are negotiable.
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:
- Bureau of Labor Statistics Occupational Outlook Handbook
- Doximity 2019 Physician Compensation Report (Source 1, Source 2)
- Merrit Hawkins 2019 Review of Physician and Advanced Practitioner Recruiting Incentives
- Medscape 2020 Compensation Overview