By Josh Katzowitz, WCI Content Director

Despite the COVID pandemic that increased burnout among physicians, average doctor salaries in 2021 rose more than twice as much as they did the year before. According to a Doximity study that included survey responses last year from more than 40,000 US doctors, the average physician salary increased an average of 3.8% from 2020 to 2021. Compare that to the 1.5% increase from 2019 to 2020, and you’ll see that, despite the world’s woes and the US healthcare system problems, doctors made more money.

“It’s possible this year’s increase reflects a catch-up from last year’s relatively flat rate, a tight labor market, or a reflection of rising inflation rates in 2021,” the study’s authors wrote.

Even with the increase in doctor salaries, though, the rise in compensation did not keep up with the approximate 7% inflation numbers from 2021, meaning that doctors still experienced a decline in real income last year (of course, that’s no different than most other industries that didn’t average a 7% increase in salaries). Plus, consider that inflation, in July 2022, reached 9.1%.

That also means a doctor's net worth also might not have risen much, if at all, in the last year despite the salary increases.

In another Doximity article released in August 2022, a survey of more than 1,000 doctors found that more than half of them are either delaying retirement (about 40% of those who were surveyed) or reducing their expenses (about 15%) because of the current economic environment. According to Doximity, “Older physicians, who are closer to the traditional retirement age, are much more likely to delay retirement than younger physicians. But a substantial percentage of those in their 30s and 40s are also planning to delay retirement.”

According to Doximity’s data, the gender pay gap was also wide at 28%, as male doctors earn about $122,000 more than their female colleagues per year and about $2 million more over the course of their careers. That disparity also could have led to more cases of physician burnout.

“The widening gender pay gap may be a contributing factor to burnout among women physicians,” Doximity wrote. “Research has found that women physicians carried the burden of increased childcare during the pandemic and were more likely to consider early retirement due to burnout. We found that 25% of women physicians considered early retirement due to COVID overwork.”

 

Average Doctor Salary

In reality, the average doctor's salary isn't all that useful to know.

As an example: according to the Doximity report, the average pediatric infectious disease doctor makes $210,844 per year. The average neurosurgeon makes $773,201. Between those two, the average is $492,023. Which, when comparing those two specialties, means absolutely nothing. Plus, consider that, according to Medscape, the average primary care physician makes $242,000 vs. a specialist who makes $344,000. That's also a pretty big difference.

It's almost certainly more useful to know the average in a doctor's speciality as opposed to the salary of a physician in general.

 

Intraspecialty Pay vs Interspecialty Pay

As Dr. Jim Dahle has repeatedly pointed out, “One of the things I have noticed, that no one ever seems to talk about, is that intraspecialty pay variation is higher than interspecialty pay variation.”

As Jim noted in a previous post, here’s a chart from 2015 that shows the results of an Emergency Medicine salary survey. The salaries might be outdated, but the general point remains.

 

Salary Survey

He wrote:

“Look at the 10th percentile for employees—$213,000. Now, look at the 90th percentile for partners—$510,000. Difference? $297,000. GREATER than the difference between the average pediatrician and the average plastic surgeon!

The ability to increase pay and increase it substantially solves a ton of financial problems that real doctors run into and email me about all the time. It's way easier to pay off your student loans or mortgage on twice the income. Even after-tax, it's much easier to become financially independent or have a dignified retirement or send your kids to the college of their choice when you can double your income.”

 

How Much Do Doctors Make an Hour?

Physician income information is relatively easy to find, but work hours information is notoriously difficult to find. The only information that combined physician work hours with their income is from a survey in JAMA published in 2003 (and obviously using even older data).

The below physician salary per hour combines the JAMA data from 2003 with Medscape’s 2021 survey, and it's adjusted for the decreased work hours in each specialty. This chart (possibly erroneously) assumes that all physicians work 48 weeks a year. Where Medscape didn’t have survey data, other less reliable sources were used. Those figures have an asterisk next to them in the table.

 

Physician Salary Per Hour by Specialty

 

Specialty Income Work Hours per Week Work Hours per Year (X 48) Income Per Hour
Anesthesiology $378,000 59 2832 $133
Cardiology $459,000 55* 2640 $174
Dermatology $394,000* 44 2112 $187
Emergency Medicine $354,000 44 2112 $168
Family Practice $236,000 51 2448 $96
Gastroenterology $406,000 55* 2640 $154
General Surgery $373,000 58 2784 $134
Hospitalist $217,000 44* 2112 $103
Internal Medicine $248,000 55 2640 $94
Neurology $290,000 54 2592 $112
OB/GYN $312,000 59 2832 $110
Ophthalmology $379,000* 45 2160 $175
Orthopedic Surgery $511,000 56 2688 $190
Otolaryngology $417,000 52 2496 $167
Pathology $316,000* 44 2112 $150
Pediatrics $221,000 52 2496 $89
Psychiatry $275,000 46 2208 $125
Pulmonology $333,000 55* 2640 $126
Radiology $413,000 56 2688 $154
Urology $427,000 59 2832 $151

 

Doctor Salary by Specialty

One interesting thing about salary surveys, of course, is that they are garbage in/garbage out. Average specialty pay varies significantly between surveys. Before we focus on the Doximity numbers, which you'll find in the paragraphs below, compare and contrast those numbers with those from the Medscape survey published just eight months previously.

 

Medscape Salary Survey

 

Medscape says pediatricians make $221,000. Doximity says $251,000. That's a 14% difference. Medscape says orthopedists make $511,000. Doximity says $633,000, 24% more. What is a new grad or even an established doc who is wanting to negotiate a contract supposed to do with that much variation between averages (besides use the Doximity survey when negotiating)? And what if you're in one of those “specialties in the middle” like OB/GYN or Psychiatry or Emergency Medicine or Neurology that Doximity didn't even report on despite how common they are? Or if you're a Neurosurgeon or CT surgeon, and Medscape doesn't report on your specialty? Are you stuck paying $965 (or hiring a contract management firm) to get MGMA data? Is that data even any better than these surveys?

 

Highest Paid Doctors

Now, for the Doximity survey numbers that tell us the highest-paid and the lowest-paid doctors. When it comes to the top-earning specialties, those in surgical and procedural specialties dominated the list, and doctors who earn the least mostly practice in primary care and pediatrics.

So, how much do doctors make? Here’s what Doximity found.

highest average doctor salaries

Lowest Paid Doctors

And here are the specialties that earn the lowest salaries.

lowest average doctor salaries

Keep in mind that these charts are of the top-20 highest and lowest average doctor salaries. So, for specialties like psychiatry, adult emergency medicine, and allergy and immunology, those average salaries likely range from about $311,000 to about $384,000.

As for which specialty's salaries are increasing vs. those that are decreasing, here's a chart put together by Medscape.

doctor salary increasing decreasing

Even during a pandemic when many cosmetic surgeries had to be curtained, plastic surgeons continue to make more money, as do oncologists and surgeons. While dermatology remains one of the tougher specialties that one can match into, those salaries have dropped slightly.

More information here:

How Much Do Surgeons Make?

 

Doctor Salary by State

One way to get closer to financial independence is to practice geographic arbitrage, where a doctor lives in a lower cost of living area and draws a higher salary where the need for physicians might be greater than those in the big cities on the coasts. The following chart from Medscape seems to show that geoarbitrage is not a myth.

Doctors make the highest salaries in states like Alabama, Kentucky, Oklahoma, Indiana, and Missouri. All are so-called flyover states, and none are in the top-15 among the states with the biggest populations.

 

doctor salary by state

Obviously, a doctor living in New York City is going to have a much higher cost of living than a physician who's residing in Florence, Alabama. The fact that doctor in the Yellowhammer State probably brings home more money than that physician in the Big Apple is also another point in favor of practicing geographic arbitrage.

 

Increasing Doctor Salaries

Just because certain specialties didn’t make the top-20 list doesn’t mean those physician salaries are staying flat. As noted in the Doximity survey, here are the top-five specialties with the highest increase in average doctor salary in 2021 (notice the difference between this list and the one above from Medscape).

  • Preventative Medicine: $264,539 (a 12.6% increase)
  • Hematology: $357,292 (a 12.2% increase)
  • Nuclear Medicine: $398,544 (a 10.4% increase)
  • Pediatric Nephrology: $247,861 (a 9.5% increase)
  • Occupational Medicine: $310,934 (an 8.4% increase)

The setting in which a doctor practices also heavily affects how much they earn. As you can see below, the difference between practicing in a single-specialty group vs. working for the government can be nearly $180,000 a year.

average doctor salaries

    • Single Specialty Group: $442,024
    • Multi-specialty Group: $424,312
    • Solo Practice: $415,678
    • Hospital: $399,282
    • Industry/Pharmaceutical: $395,560
    • Health System/IDN/ACO: $394,538
    • Health Maintenance Organization: $374,571
    • Academic: $350,232
    • Urgent Care Center/Chain: $267,516
    • Government: $264,546

 

 

Need tips for how to increase pay in your specific specialty? Jim has some ideas.

To read the entire Doximity report —which also includes information on physician compensation in different metro areas, cities with the fastest-growing doctor salaries, and COVID’s impact on physician retirement—click here. Here’s even more information if you’re looking for a doctor’s hourly rate, broken down by specialty.

What do you think? Are you surprised by any of these numbers? Have you found a way to increase your pay inside your specialty? Comment below!