The 20 highest paid specialties in 2023 as doctors see 6% boost in pay: Doximity

After several years of modest or declining growth, the average pay for doctors jumped 5.9% in 2023, rebounding from a decline of 2.4% in 2022.

Most medical specialties experienced positive growth in 2023, with the top 10 seeing annual growth rates exceeding 7%, according to the 2024 Physician Compensation Report (PDF) from professional medical network Doximity. 

Among specialties, hematology and family medicine claimed the top two spots, with double-digit percentage growth compared to 2022 (12.4% and 10.2%, respectively). 

However, inflationary pressures continue to impact physicians’ real income. According to the American Medical Association, when adjusted for inflation, Medicare physician payment has dropped 26% since 2001.

Doximity's compensation data draw from nearly 150,000 survey responses over five years, including responses from more than 33,000 U.S. physicians in 2023 alone.

The report dives into trends with compensation, workload and physician shortages and how they are impacting doctors' perspectives of their careers.

Only 40% of physicians surveyed reported they are satisfied with their current salary and compensation package, according to the report. Rather than negotiate a pay increase, 75% of physicians surveyed reported they are willing to accept, or have already accepted, lower pay for more autonomy or work-life balance.

Eight out of 10 doctors report they are overworked, and 59% said they are considering an employment change, including early retirement (30%).

“The U.S. health care system continues to face significant challenges that are taking a toll on even the most dedicated medical professionals,” said Nate Gross, M.D., co-founder and chief strategy officer of Doximity. “Physicians are increasingly tasked with achieving more with less. The goal of this report is to empower physicians to advocate for themselves and make better-informed career decisions.”

Consistent with prior years, physician compensation showed significant variation depending on the practice setting, with single specialty groups, multispecialty groups and solo practices ranking highest in average annual compensation after adjusting for specialty.

Progress on gender pay gaps

The gap in pay between male and female physicians decreased to 23%, down from 26% in 2022 and 28% in 2021.

Still, female physicians earned less than male physicians in every medical specialty.

Despite this progress, the pay gap remains significant, with female physicians earning nearly $102,000 less than male physicians, on average, after controlling for specialty, location and years of experience, according to the report.

It's also important to consider it in the context of the overall compensation trends observed in 2023. Notably, this reduction occurred at only half the rate of the 6% increase in average physician compensation during the same period.

An analysis of Doximity's physician compensation data from 2014-19 estimated that over the course of a career, male physicians make over $2 million more than female physicians.

Data also show that awareness of the gender pay issue among many physicians appears to be lacking. Nearly half of physicians surveyed (48%) are either unsure about the gender pay gap or do not believe there is a disparity, and this number is even higher among men.

Administrative burden, staffing shortages put stress on physicians

Overall, the majority of physicians (62%) do not believe their pay matches the level of effort and expertise required in their role. Heavy workloads and high administrative burden appear to be so problematic that many physicians are either considering accepting lower compensation for more work-life balance or leaving clinical practice altogether.

In February and March this year, Doximity surveyed more than 1,000 physicians regarding their career and compensation satisfaction. More than 39% of female physicians said they are satisfied or very satisfied with their compensation compared with about 40% of men. Similarly, 35% of both male and female physicians said they are dissatisfied or very dissatisfied with their compensation.

Consistent with prior years’ findings, feelings of overwork continue to be more prevalent in female physicians. Among female physicians surveyed, 89% reported they are overworked compared with 77% of male physicians, 82% of female NPs and PAs and 78% of male NPs and PAs.

Overwork also appears to be more prevalent in younger physicians, with 89% of physicians age 29 and under reporting they feel overworked.

"Women physicians often face a third and fourth shift, balancing the rigorous demands of their medical careers with disproportionate expectations at home. Many of these expectations, both at work and at home, are uncompensated, unpromotable, and unappreciated," Shikha Jain, M.D., an oncologist, said in a comment included in Doximity's report.

To alleviate overwork and burnout, 75% of physicians suggested reducing administrative burden, a response more prevalent than increasing compensation or reducing patient caseloads.

A report published by the Association of American Medical Colleges projects that the U.S. will face a physician shortage of up to 86,000 physicians by 2036.

Most physicians (88%) said their clinical practice has been impacted by the physician shortage, with 74% describing the shortage as “moderate” or “severe.”

The doctors surveyed also believe the shortage has negatively impacted patients, leading to longer wait times (87%), diminished access to care (75%), worse healthcare disparities (75%), frustration or anger (74%) and delayed treatment (70%). 

As physician burnout and workforce shortages persist, physicians are concerned about the future of patient care. Looking ahead, 86% of physicians are concerned about the U.S. healthcare system’s ability to care for an aging population.

Highest- and lowest-paid doctors in 2023

Which specialties are doing the best when it comes to annual compensation? Doximity found that the 20 specialties with the highest average annual compensation in 2023 tend to be surgical and procedural specialties treating adult patients.

Neurosurgery comes out on top, followed by thoracic surgery, orthopedic surgery, plastic surgery and oral and maxillofacial surgery.

The specialists with the highest pay didn't necessarily see the biggest bumps in growth in 2023. Following hematology and family medicine, infectious disease physicians saw their pay increase by 9%, plastic surgeons by 8.5% and occupational medicine saw an average 8.5% pay bump. Oral and maxillofacial surgery, nephrology, pediatric emergency medicine, oncology and psychiatry also saw high single-digit pay increases.

The specialists with the lowest annual compensation tend to be pediatric and primary care doctors. Pediatric endocrinologists had the lowest annual compensation ($217,875) followed by pediatric nephrology ($227,450), pediatric rheumatology ($233,491), pediatric infectious disease ($236,235) and medical genetics ($244,517).

Family medicine doctors had average pay of $300,813, and internal medicine specialists brought in $312,526 in 2023.

Here are the top 20 specialists by average pay:

1. Neurosurgery — $763,908

2. Thoracic surgery — $720,634

3. Orthopedic surgery — $654,815

4. Plastic surgery — $619,812

5. Oral and maxillofacial surgery — $603,623

6. Radiation oncology — $569,170

7. Cardiology — $565,485

8. Vascular surgery — $556,070

9. Radiology — $531,983

10. Urology — $529,140

11. Gastroenterology — $514,208

12. Otolaryngology — $502,543

13. Anesthesiology — $494,522

14. Dermatology — $493,659

15. Oncology — $479,754

16. Ophthalmology — $468,581

17. General surgery — $464,071

18. Colon and rectal surgery — $455,282

19. Pulmonology — $410,905

20. Emergency medicine — $398,990