By Dan Miller, WCI ContributorTo the everyday (non-physician) person, all doctors are “rich.” And it is true that while many physicians should be considered rich, there is a wide variety of income levels across different medical specialties. That's not taking into account the above-average expenses of a doctor who makes an above-average income.
The Financial Landscape for Physicians: An Overview
Many factors influence how much a physician earns—including specialization, location, experience, and the type of practice that they have. The 2024 Medscape Physician Compensation Report is one way of measuring physician compensation. In addition to examining overall physician compensation, the Medscape report gives data on which medical specialties earn the most and which ones have the highest net worth.
Highest-Earning Medical Specialties in 2024
According to the 2024 Medscape report, these are the five highest-earning medical specialties, along with their average annual salary:
- Orthopedics — $558,000
- Plastic Surgery — $536,000
- Cardiology — $525,000
- Urology — $515,000
- Gastroenterology — $512,000
The lowest-earning specialties were Public Health & Preventive Medicine, Infectious Diseases, Pediatrics, and Diabetes & Endocrinology.
It's important to understand a few things when looking at this data. First is that this is only one survey, so it gives only a specific snapshot. There is likely a wide range of incomes, even among physicians within the same specialty. The other thing to keep in mind is that even the lowest-paid physician generally makes well above the national median salary.
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Specialties with the Highest Net Worth (Or How Many Doctors Are Pentamillionaires?)
Medscape also released a 2024 Physician Wealth & Debt Report, which gives insight into the net worth of physicians. Overall, 25% of physicians have a family net worth of under $500,000, while 11% of doctors are pentamillionaires (with a net worth of more than $5 million). Unsurprisingly, there was a wide range in the net worths of physicians of different specialties, which correlated strongly to the specialties with the highest salaries.
Here are the top five physician specialties, as ranked by the percentage of physicians in that specialty with a net worth of more than $5 million:
- Urology — 33%
- Gastroenterology — 31%
- Radiology — 31%
- Cardiology — 28%
- Orthopedics — 28%
The specialties with the lowest percentage of pentamillionaires were psychiatry (6%) and family medicine (9%).
Factors Contributing to Wealth in Certain Specialties
There are a few reasons why certain physician specialties tend to accumulate wealth faster, including:
- Workload and Time Commitment — Specialties with longer hours and more on-call demand tend to earn more money than those who have a more balanced schedule.
- Reimbursement Rates — Some specialties benefit from high procedure-based reimbursements.
- Practice Ownership — Certain specialists are more likely to own practices vs. salaried roles, which can help increase their overall net worth.
Another factor that contributes to overall physician wealth is how doctors manage debt. While most physicians make well above the national median salary, many physicians have higher-than-average expenses and debt—including medical school loans, mortgages, and possible business loans.
While the Medscape report did say that more than 90% of physicians live within their means, how individual doctors handle their debt will have a lasting impact on their overall net worth and wealth. Physicians in certain specialties may handle debt differently, potentially affecting long-term wealth accumulation.
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Beyond Income: Wealth-Building Strategies for Doctors
While there is a healthy positive correlation between one's annual salary and their net worth, the two things are not the same. There are many reasons why someone with a high annual income may not have a correspondingly high net worth. This could include high levels of debt, not living within your means, and making poor investment choices (including not investing at all).
Building an investment portfolio for long-term success is crucial if you want to translate your high salary into a high net worth. While it's important to understand that you shouldn't try to take shortcuts in building your investment portfolio, there are a few simple steps that anyone can take. These include setting goals, developing and implementing an asset allocation that's right for you, and sticking with the plan.
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The Bottom Line
While most physicians make well above the national median annual income, there is a wide range of income levels between different medical specialties. There are many factors that go into why certain specialties have higher incomes than others—including workload, time commitment, demand, and practice ownership.
In addition to affecting your annual salary, your choice of specialty also has a big impact on your potential net worth and long-term financial success. If you are an aspiring physician, it can be a good idea to consider both passion and financial goals when choosing a specialty. Make sure to continue to follow The White Coat Investor for more tips on how to maximize your income and net worth.
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