A list of the 20 highest paid specialties in 2021 as average pay for doctors slumps amid rising inflation: Doximity

The financial and workplace pressures brought on by the COVID-19 pandemic are putting a major strain on physicians, impacting their pay as well as job satisfaction, according to a new survey.

The average pay for doctors increased by 3.8% from 2020 to 2021, which is up from a nominal increase of 1.5% last year, according to the fifth annual Physician Compensation Report (PDF) from professional medical network Doximity. 

However, like last year, the increase did not outpace the rate of inflation. In 2021, the 12-month headline inflation rate was 6.2% as measured by the Consumer Price Index. So, when compared against the 2021 inflation rate, doctors experienced a decline in real income, Doximity reported.

The overall 3.8% pay increase matches up with the pre-pandemic growth rate of 4% and may be attributable to the tight labor market for clinicians.

The pandemic also has taken a toll on physicians' desire to stay in the medical profession, with data suggesting doctors are speeding up their retirement plans.

An analysis of Medicare claims data shows major disruption to practice patterns at the onset of COVID-19, coinciding with an increase in physician retirement, representing an extra 1% of the physician workforce. Given that the pandemic continues and that physicians report increasing rates of burnout, this is concerning for 2022 physician retirement trends and the growing physician shortage, according to the report.

RELATED: The list of the 20 highest paid specialties in 2020 as average physician pay dips: Doximity

About three-quarters of physicians (73%) reported feeling overworked, and about half reported considering an employment change due to COVID-related overwork. Notably, female physicians are considering early retirement at higher rates than their male colleagues.

“Medical professionals’ responsibilities, hours and stresses grew dramatically during the pandemic and, as a result, we’ve seen an increase in burnout, especially among female physicians. For that reason, this is the first year our study has surveyed physicians regarding their retirement plans,” said Peter Alperin, M.D., vice president of product at Doximity, in a statement. “By tracking this new data, as well as the compensation information we’ve reported on for years, we hope to provide the medical community with a framework to help it understand employee’s sentiments, hiring needs and dynamics.”

The survey was based on responses from 46,000 full-time and part-time physician surveys, of which over 40,000 were full-time and used for the compensation comparisons. The study also provides five years of year-over-year trends data, gathered from surveys of over 160,000 physicians,15,000 nurse practitioners and 10,000 physician assistants from 2017 to 2021.

Among its key findings, the study indicates that the gender pay gap persisted this year with female physicians earning 28% less than male physicians; a delta of more than $122,700. That gap increased from 26.5% in 2017 to 28.2% this year. Among nurse practitioners and physician assistants, the gender pay gaps have been steadily declining over the last five years and are now 11% and 10%, respectively.

"This indicates that some healthcare roles may be better at organizing and advocating for themselves. Physicians feel like they have to advocate independently and that comes down to personal negotiation skills and doctors really don’t get any training for that," Natalia Birgisson, M.D., director of strategy at Doximity, told Fierce Healthcare. 

RELATED: The list of the top 10 highest physician salaries by specialty for 2019

Doximity provides resources such as salary maps to show compensation trends at the local and regional levels to help physicians when entering negotiations with employers, Birgisson noted.

"But the gender pay gap is a systemic issue that requires a commitment from health systems and employers to address," she said.

The top three cities with the highest physician compensation were Charlotte, North Carolina ($462,760), St. Louis ($452,219) and Buffalo, New York ($426,440). Those cities also are the top three for physician pay when adjusting for cost of living, the report found.

Cities with the lowest compensation when adjusted for cost of living tend to be on the East or West coasts such as San Francisco, Washington, D.C., and Baltimore.

While compensation increased across all specialties in 2021, growth rates varied significantly. Many of the specialties with the highest growth in compensation are notably small specialties and may be subject to tight labor markets or regional hiring trends, the authors of the report said.

Among the specialties experiencing the most growth right now, the report shows preventive medicine specialists were on top at $264,539, a whopping 12.6% increase in their average compensation in 2021 over 2020. 

Likewise, hematology and nuclear medicine both saw double-digit increases in compensation. Pediatric nephrology, occupational medicine, oral and maxillofacial surgery, otolaryngology, pediatric gastroenterology, allergy and immunology and radiation oncology all saw a more than 5% jump in their average annual compensation between 2020 and 2021.

So which specialties are doing the best when it comes to annual compensation? Here's a look at what Doximity found: 

1. Neurosurgery – $773,201

2. Thoracic surgery – $684,663 

3. Orthopedic surgery – $633,620

4. Plastic surgery – $556,698

5. Vascular surgery – $552,313 

6. Oral and maxillofacial – $545,471 

7. Radiation oncology – $544,313

8. Cardiology – $537,777

9. Urology – $514,922 

10. Gastroenterology – $500,400

11. Otolaryngology (ENT) – $497,157

12. Radiology – $495,451 

13. Dermatology – $476,263

14. Anesthesiology – $457,867 

15. Ophthalmology – $454,997 

16. General surgery – $451,151

17. Oncology – $447,112

18. Colon and rectal surgery – $445,730 

19. Nuclear medicine – $398,544

20. Pulmonology – $385,602