Methodology

For the report, Medscape surveyed 7,000 physicians across more than 29 specialties between October 2, 2023, and January 16, 2024.

In the survey, physicians reported their total compensation for providing care. For employed physicians, the figure included their salary, bonus, and income from profit-sharing arrangements, while self-employed physicians reported their earnings before factoring in income taxes but after factoring in business taxes and deductibles. Only full-time salaries were included in the report.

Overall physician compensation rises

Overall, the report found that physician compensation rose around 3% in 2023, with pay rising around 4% for an average primary care physician, and by around 3% for a doctor who practiced in one of the surveyed specialties.

Specifically, the report found that average compensation for all physicians was $363,000 in 2023, compared to $352,000 in 2022. Among primary care providers, average compensation rose from $265,000 in 2022 to $277,000 in 2023. Among specialists, average compensation rose from $382,000 in 2022 to $394,000 in 2023.

"Since we came out of COVID, physicians have been back in the driver's seat where job offers and contract negotiations are concerned," said Jeff Decker, president of AMN Healthcare's physician solutions division. However, Decker added that many physicians are choosing to exercise their leverage for greater schedule flexibility rather than more money.

The report noted that while compensation rose an average of 3% in 2023, that rise was less than the 4% average increase for nonunionized U.S. employees in the same year, according to Mercer. In addition, a 2% Medicare reimbursement cut implemented in 2023 also hurt income for many physicians, the report said.

And despite the rise in pay, Medscape found that 61% of respondents said they believe "most physicians are underpaid" compared to 34% who said that "most physicians are overpaid" and 5% who said that "most physicians are paid about right."

However, when Medscape asked respondents, "do you feel fairly paid, given your work demands?" only 51% of respondents said no.

"I think their response is a function of their lens — 'I feel fortunate to have a job, to care for my patients, to be paid for this work,'" said Elizabeth Woodcock, principal at Woodcock & Associates. "The reflection about being paid well is more of a reflection about their personal narrative."

Average compensation by specialty

The report found that orthopedic specialists were the highest paid specialty on average last year, with average annual earnings of $558,000, followed by plastic surgery at $536,000. Meanwhile, the lowest paid specialty last year was diabetes and endocrinology, with average annual earnings of $256,000.

"As a rule of thumb, the specialists who generate the most gross billings to commercial payers are likely to receive the highest compensation," said Decker. "Physicians who mostly provide consultations are likely to be toward the bottom, even if both services are equally valuable from a clinical perspective. That's just the reality of how physicians are compensated in our system."

Specialists in public health and preventive medicine were most likely to feel happy about their level of compensation, while specialists working in infectious diseases were least likely to feel happy with their compensation.

How compensation varies by gender and race

The report also found that the gender pay gap in healthcare was still significant in 2023, with male physicians practicing full time making an average of around 29% more than their female counterparts.

The gender pay gap among primary care physicians favored men at 17%, down from 19% in 2022, but the pay gap among specialists was around 31%, up from 27% in 2022.

"The survey reflects reality: Female physicians are often less engaged in negotiations about compensation" than their male counterparts, "and a failure to do that at the beginning of their career sets the stage for a lifetime of lower compensation," Woodcock said. Women could help themselves by being more willing to change medical practices, which would help their bargaining power, she added.

Meanwhile, the report also found gaps in average compensation by racial and ethnic background. On average, white physicians earned $369,000 per year, while Black physicians earned an average of $332,000 per year.

However, the report noted that average compensation for African American/Black physicians grew twice as fast over the past year than it did for any other racial and ethnic group. (McKenna, Medscape, 4/12; Muoio, Fierce Healthcare, 4/12; Commins, HealthLeaders Media, 4/11)

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