By Joe Dyton, WCI Contributor
If you’re a physician looking for a change of scenery in hopes of increasing your salary, here are the best and worst metro areas for doctor salaries.
Best Metro Areas for Physician Salaries (by Location)
According to the 2025 Doximity Physician Compensation Report, physicians in the US saw a 3.7% increase in compensation from 2023 to 2024 (and that's after a nearly 6% compensation increase between 2022 and 2023). Meanwhile, physicians in Rochester, Minnesota, enjoyed one of the largest pay spikes at 8.7%, and the average pay there is now $495,532. Meanwhile, physicians in the San Jose metropolitan area—which had one of the largest pay spikes in 2023 at 13.5%, propelling it to the top spot on last year's list—actually saw a decrease of 1.07%, though it still remains in the top five. Rochester didn't even make the top 10 list last year.
Among the 10 metropolitan areas with the highest average compensation last year, five of them are located in the state of California. All of them, except for San Jose, saw a positive increase in compensation in 2024.
Worst Metro Areas for Physician Salaries (by Location)
While five of the top 10 metro areas with the highest compensation for physicians were based in California, the report’s 10 locations with the lowest compensation were more spread out across the eastern half of the country. The Durham-Chapel Hill metro area had the lowest average compensation for physicians with a $358,782 annual salary. San Antonio, which was the lowest in 2023 at $371,073, saw a 4.96% increase in salary for 2024, though it's still among the top 10 worst metro areas.
Also, make sure that if you're moving to Rochester for an increase in pay, you're moving to the one in Minnesota and NOT the one in New York, lest you make a $130,000 mistake. As you can see on the list below.
Best Metro Areas for Physician Salaries (Cost of Living)
How expensive it is to live in a particular metro area is perhaps the best gauge of how high a physician’s (or, really, any professional’s) salary truly is. According to Doximity, Rochester, Minnesota, also had the highest compensation adjusted for cost of living for physicians. That's followed by St. Louis, Oklahoma City, Omaha, and Kansas City. If you want to stretch out your dollar, it seems like living in the Midwest is a good way to do it.
Additionally, five of the top 10 best metro areas for physician salaries regarding cost of living made the list the year before, while cities like Buffalo and Salt Lake City were new additions.
Worst Metro Areas for Physician Salaries (Cost of Living)
A number of the metro areas that are generally known for being expensive to live in were among the worst places for physician salaries. Besides Denver, the top 10 metro areas in this category were on the East or West Coasts of the US.
Boston, No. 2 on last year's list, made it to No. 1 this year, while Washington, DC—which took the top spot last year—fell (or rose, depending on how you look at it) to No. 2. Seattle, Denver, and San Francisco rounded out the top five of the worst metro areas for physician salaries when it comes to cost of living.
East and West Coast cities making up this list is not new. These cities were also on Doximity's adjusted compensation lists in 2023, 2022, and 2021.
Below is the chart showing the highest and lowest areas for physician salaries based on the cost of living.
And if you want to look at it by region, here's what Medscape released in 2025.
Best Metro Areas for Physician Salaries (Compensation Growth)
Like any professional, physicians don’t want to just earn a high salary. They also want to see it grow throughout their career. According to the Doximity report, average physician compensation rose in 54 of the 60 metro areas studied (about two-thirds saw growth of at least 3%).
As noted by Doximity,
“While the inflation rate in 2024 returned closer to pre-pandemic levels, physicians are still feeling the effects of several years of high inflation—including 7% in 2021 and 6.5% in 2022—and ongoing Medicare payment cuts, including another 2.8% cut in 2025. According to the American Medical Association, Medicare physician payment has dropped 33% since 2001, after adjusting for inflation.”
Austin physicians saw the biggest physician compensation growth (11.1%), with the Kansas City metro area not far behind at 10.0%. The Buffalo, Orlando, St. Louis, and Nashville metro areas also experienced salary increases of more than 9% on average. Rochester, Minnesota, grew by 8.7%.
The Bottom Line
The phrase “location, location, location” is often reserved for real estate, but it can apply to physician salaries as well. Doctors can make a handsome salary wherever they practice, but that six-figure income goes a lot further in some metro areas than others. So, as you look for a place to work, don’t just look at the regions that pay the most; also consider the cost of living and how much your salary may grow from year to year. Combining all of these factors will give you the most realistic look at what your physician's salary will be.
Looking to increase your income or renegotiate an existing contract? Hop on over to the WCI physician contract review page, where you can find vetted lawyers and compare your contract to other docs.
Do you live in one of the metro cities that's either on the best or worst lists? Have you moved around to find the best combination of high salary and low cost of living? Is that something you would consider?
Does this control for the type of medicine practiced in each area
I don’t think so. But one would assume if metro areas were of similar sizes they would have similar amounts of each specialty.
Interesting article for sure. It surprising that more physicians don’t take advantage of geographical shifts in salary, because when coupled with cost of living as you mentioned, the discrepancies can be somewhat extreme. I think the aspect of increasing physician salaries is also a little misleading, especially because reimbursements have steadily gone down least for Medicare over the past 5 years, and definitely do not keep up with inflation and the costs of running a practice. The value of our work has objectively decreased, and sometimes that can be offset by increasing reimbursement with private payers, if you have that kind of leverage in your market and work for a larger entity. I think the underlying trend here is that the average physician workload in order to justify these so-called salary increases is probably much more dense than it was 5 to 10 years ago, and you don’t really have a lot of physicians making high ceiling salaries unless they are in a well-established larger private practice, since more more physicians every year are hospital / PE employed, and probably get a higher base salary, but have very little potential for growth beyond that. I also don’t feel that many new physicians care to run a business and help manage a practice, in exchange for higher compensation.
If your goal is to actually be rich as a doctor, “ball” out, and retire early – the recipe is simple: sub specialize, and join a private practice with an actual opportunity for equity in an area where there is little competition and your services are in demand (usually Midwest and South). W2 income in Iowa for me is approximately $1.5M and my wife is that not much less as a private practice oncologist. It isn’t uncommon for busy hard working physicians in sub specialties to generate such sums and have tremendous purchasing (and saving) power with very negligible life overhead. You also seldom feel pressure to spend more money to keep up with others, as you would in a coastal city – another added benefit.
Thats cool and all but i could never see myself middle of nowhere Iowa which by the way I briefly grew up in. I lived in a midwest city where supposed low cost of living with geographic arbitrage existed but thats not always the case. The employer payment plan can change, finances rise and fall for them. Also, if you dont have a heavy practice base with lots of patients it can be a struggle and in this day and age of medicare advantage plans paying more than private insurers, the other arbitrage is living in a state with older people.
I work on the coast as a primary care provider and make well over 600k a year outpatient only and 10 min from the beach. My cost of living is nowhere near seattle or boston. Ill take this anyday over iowa.
Just to clarify, not in the middle of nowhere Iowa, 20 minutes from Des Moines, with plenty of direct flights across the US, and good public schools. I’m actually going to Costco on the way home, and will probably grab Chipotle for dinner. A common misconception especially amongst new grads is that everyone living in the Midwest that makes competitive money lives in the middle of nowhere. Not true. I’m also married without children and on a given weekday, I don’t thirst for more amenities / socializing than any typical suburb has to offer, especially after a long workday. To each his or her own, I’m glad your doing well financially near the beach – I can’t swim.
Interesting mention about Medicare Advantage. First time I’ve heard that.
Agree private practice is the way to go. Crazy that the trend is for less and less to go into private practice and to willingly hand over both control and wealth. When we recruit new docs to our practice we have significant struggle trying to show the big picture and not just a one year salary guarantee or a astronomical signing bonus that employed physicians are offered to rope them in. Survey after survey shows that private practice docs are the most happy and in general continue to financially outperform significantly other employment models. Increased autonomy and reimbursement goes a long way. Yet new physicians are shunning this with increasing numbers. We are willingly allowing out profession to be gutted. Sad to watch.
The control will matter a lot more ten years out of training than it does immediately after when people are thinking about that first home and a big pile of student loans.
Thanks for sharing your specific example of geographic arbitrage. I talk about it all the time but I don’t think many docs even believe me.
I feel poor after reading this article and the comment above. Wow.
Ignorance is bliss they say. But I’m not a big fan. If people make less, I want them to choose to do so because they value something else so highly.
Good read. The reality is that most physicians, like most people, do not know their value objectively. They do not know how much or how little they are actually bringing in. Without objective data, it is very easy to end up being taken advantage of.
I wonder whether salaries in DC, Baltimore, and San Antonio are affected by the number of military docs there.