Physicians and nurses are the primary face of the health system for patients. We all want our physicians to be happy, to not be stressed and to be fully attentive to the work they are doing. Part of that job satisfaction is compensation. The average physician spent a lot of time getting to the point where they could practice and ran up debt in doing so. They typically work long hours and deal with emotional and difficult health issues. So being well paid seems fair. At the same time, what we pay doctors compared to other countries is one of the reasons we have very high health spending. A recent report from Medscape looks at recent trends in physician compensation. (Medscape Report)
Overall, in 2023 physician compensation was about 3% higher than in 2022, with primary care doctors seeing a slightly larger increase than specialists. Average pay was $363,000 in 2023 versus $352,000 in 2022. Not much to complain about, really. Primary care physician pay averaged $277,000 compared to $394,000 for specialists. I see this gap as unwarranted in terms of value to the system and to patients. Good primary care keeps you healthy and limits unnecessary costs, but specialists train for longer and deal with more complex issues, which is reflected in their pay.
The highest paying specialties were orthopedics, an average of $558,000; plastic surgery (which is largely fee for service), $536,000; cardiology, $525,000 and urology, $515,000. At the lower end it is mostly primary care, although diabetologists/endocrinolgists were at $256,000, with pediatrics at $260,000, infectious disease, $261,000 and family medicine, $272,000.
Over 60% of doctors report feeling underpaid. The American public doesn’t share that view, with only 11% accepting it. And a substantial number of doctors do extra work outside their main job to get more income.
The Healthy Skeptic is a website about the health care system, and is written by Kevin Roche, who has many years of experience working in the health industry. Mr. Roche is available to assist health care companies through consulting arrangements through Roche Consulting, LLC and may be reached at 
Apple Podcasts
Google Podcasts
Spotify
Overcast
PocketCasts
Radio Public
Stitcher
Anchor
RSS - Posts
“At the same time, what we pay doctors compared to other countries is one of the reasons we have very high health spending.”
Is it? It seems there are something like 1 million physicians in the US. At $360K per, that is $360 billion. A lot of money, but just 8% of the $4.5 trillion in health care spending.
Physician services account for about 25% to 30% of all US health care spending. Compensation to the physician is obviously only a part of the cost–office space, office staff, equipment, etc., all figure in. Physicians in the US earn from 50% to 100% more than their counterparts in other developed countries. In general, the difference in per capita spending in the US is all due to higher prices for services, not more utilization. In fact, the US does very well on ensuring utilization of services is appropriate.
In 20 years, there will not be any primary care, family practice or pediatricians. The cost of medical school continues to rise and the wages primary care providers make – being on the front lines – is no longer in balance. No one in medical school is signing up – and the primary care residencies are not filling. A trend that continues and you will not have a doctor.
We need a fundamental shift on how physicians are paid.