How much money do US doctors make?

by Pat Salber, MD, MBA of The Doctor Weighs In

According to the 2015 Medscape Physician Compensation Report,* the average compensation of primary care physicians in the US make is $195,000 and specialists, $284,000. The median income for people in the US last year was $51,939.**

Who earns the most?

Orthopedic surgeons are the top earners, coming in at $421,000 — I guess all that unnecessary back surgery really pays off. (Just kidding! or not!) Plastic surgeons come in 5th from the top at $354,000. This is pretty interesting, especially considering a large percentage of cosmetic surgery is paid for out-of-pocket.

At the low end of the totem pole are the primary care docs, you know the ones we need a whole lot more of. Pediatricians’ average compensation is $189,000, family physicians $195,ooo, and internists $196,000. The specialists who take care of some of the most numerous and complex patients in the country, the diabetes doctors and endocrinologists, are also down at the bottom at $196,000.

When comparing 2014 to the prior year, most docs got a raise — only rheumatologists and urologists took a slight hit. HIV/infectious disease doctors got the largest increase at 22%. Pulmonologists income increased 15% and emergency physicians, 12%. Although family physicians got a 10% increase, it didn’t help move them off of the bottom of the income list.

Breaking it down by region, state, gender and more

Although overall the Northwest had the highest average compensation for a region ($281,000), North Dakota and Alaska had the highest incomes for a state. The survey suggests that “numerous government policies…aimed at improving access to physicians in rural areas” was a major reason, however, you have to wonder if North Dakota’s oil boom also played a role.

A little over two-thirds of physicians are now employed as opposed to being in private practice. This is despite the fact that employed physicians ($189,000 primary care, $258,000 specialists) make less (in terms of cash compensation) than self-employed docs ($212,000 primary care, $329,000 specialists).

Women continue to earn less than men (as they have in all of the Medscape Physician Compensation surveys to date) although the difference has shrunk slightly (from 28% to 24%). This is in part because women tend to work fewer hours, but also because they choose lower-paying specialties (50% of pediatricians are women compared to only 9% of orthopedists).

Who is the happiest of them all?

One of the most interesting parts of the survey are the questions that reflect physicians’ satisfaction with their lot in life. In answer to a question about fair compensation, 60+% of dermatologists, emergency physicians and pathologists said they were fairly compensated.

Despite their stratospheric compensation ($421,000 per year!), only 42% of orthopedists said they were fairly compensated…what??? How much do they think they should make? And, speaking of high earners, what about the plastic surgeons — only 44% of them say they feel fairly compensated. Helping aging boomers appear young and beautiful is certainly important (and becoming even more so as gravity and the sun continue to take its toll), but surely they can scrape by on $354,000 per year.

It is fascinating that half of the lowest paid specialty, the pediatricians, feel fairly compensated. But perhaps it isn’t so surprising when we remember that these are the doctors that have sock puppets in their pockets and toys in their waiting rooms. Playing with kids is priceless, no?

When it comes to overall satisfaction with their chosen profession, dermatologists are at the top with 63% meeting the criteria for satisfaction in this survey (Medscape averaged the percentage of physicians who would choose medicine again, those who would choose their specialty again, and those who thought they were fairly compensated.)

Sixty-one percent of dermatologists were satisfied with their income, 55% would choose medicine again, and 73% would choose their specialty again. Internists were the most unsatisfied with a 47% overall satisfaction rating (45% happy with income, 71% would choose medicine again, and 25% would choose their specialty again).

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The tyranny of the 15-minute office visit

The survey confirms that short office visits are the norm for primary care. More than half of family doctors report spending 16 minutes or less seeing patients and only 9% report spending 25 minutes or more. Almost 68% of self-employed family docs spend 10 or more hours per week doing paperwork and 11% say they spend an astonishing 25 or more hours doing so. Paperwork consumed slightly less time if the doctors were employed.

The bottom line

When it comes to income, physicians, even the lowest paid primary care docs, are doing pretty well compared to the rest of Americans — they all qualify for the 1%. On the other hand, even the highest paid of the specialists aren’t making anywhere near what the super rich are making. I just read that Nick Woodman, CEO of GoPRO is the highest paid CEO in the US. He will make $284.5 million/year — of course, a lot of it is paper money (aka stock options), but still…

On the other hand, the survey results make it clear that money alone does not bring happiness…or satisfaction. Only 11% of men and 8% of women respondents said that “making good money at a job I like” was the most rewarding aspect of the job. In this survey, being good at the job, finding diagnoses and right answers and relationships with patients were what drove satisfaction.

Factors like masses of paperwork, the dreaded EHR, reduced face-to-face time with patients, long hours, night call, loss of autonomy, lack of the previous exalted place in society and other annoyances of day-to-day practice may all serve to dilute satisfaction of practitioners of a profession that was once one of the most highly sought after in the US.

Should we be worried? Probably. But I am an optimist and am hopeful that changes in medical education, practice models, and reimbursement may help with physician satisfaction as may digital health technologies and do-it-yourself health care. Of course, it remains to be seen.

Survey Methodology:

• Sample size: 19,657 US physicians across 26 specialties met the screening criteria
• Recruitment period: December 30, 2014 — March 11, 2015
• Data Collection: Via third-party online survey collection site
• Sampling error: The margin of error for the survey was +0.69%
• *US income is usually reported as median as opposed to average to avoid skewing from very high-income individuals.

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Originally posted on our blog, The Doctor Weighs In.