A new study on physician salaries is raising pointed questions about pay for US physicians and whether it contributes to rising healthcare costs – that is, if you believe the numbers are accurate.
The study was released in July by the National Bureau of Economic Research (NBER), which produces in-depth reports on a variety of topics.
The current paper is highly technical and may have languished in obscurity were it not for an August 4 article in The Washington Post that examined the findings with the claim that “doctors make more than anyone thought.”
It is indeed true that the NBER’s estimate of physician salaries seems high. The study claims US physicians made an average of $350k in 2017, the year that the researchers focused on by analyzing federal tax records.
- The NBER estimate is far higher than $294k in Medscape’s 2017 report on physician compensation – a 19% difference.
The variation is even greater for diagnostic radiologists. The NBER data claim radiologists had a median annual salary in 2017 of $546k – 38% higher than the $396k average salary listed in Medscape’s 2017 report.
- The NBER numbers from six years ago are even higher than 2022/2023 numbers for radiologist salaries in several recent reports, by Medscape ($483k), Doximity ($504k), and Radiology Business ($482k).
But the NBER researchers claim that by analyzing tax data rather than relying on self-reported earnings, their data are more accurate than previous studies, which they believe underestimate physician salaries by as much as 25%.
- They also estimate that physician salaries make up about 9% of total US healthcare costs.
What difference is it how much physicians make? The WaPo story sparked a debate with 6.1k comments so far, with many readers accusing doctors of contributing to runaway healthcare costs in the US.
- Meanwhile, a thread in the AuntMinnie forums argued whether the NBER numbers were accurate, with some posters warning that the figures could lead to additional cuts in Medicare payments for radiologists.
Lost in the debate over the NBER report is its finding that physician pay makes up only 9% of US healthcare costs. In a medical system that’s rife with overutilization, administrative costs, and duplicated effort across fragmented healthcare networks, physician salaries should be the last target for those who actually want to cut healthcare spending.
Are you a glass-half-full or a glass-half-empty kind of person? Either way, there’s lots to unpack in the latest data on physician salaries, this time from Medscape.
Medscape’s survey of over 10k US physicians across over 29 medical specialties found that overall physician salaries have grown 18% over the last five years, to $352k, while specialists made an average of $382k.
As with last year, radiologists landed in the top 10 of highest-compensated specialists, a finding that’s in line with previous salary surveys, such as from Doximity. Medscape found that radiologists had an average annual salary of $483k in 2023, compared to $437k in 2022. Radiologists had an average annual salary of $504k in the Doximity data.
Other nuggets from the Medscape survey:
- “Stagnant” reimbursement relative to rising practice costs has cut into physician income.
- The gender gap is narrowing. Male primary care doctors in 2023 earn 19% more than females, compared to about 25% previously.
- Male specialist physicians earn 27% more than females, down from 31% last year and 33% the year before that.
- Only 19% of radiologists are women – one of the lowest rates of female participation among medical specialties.
- 58% of radiologists feel they are fairly paid.
- Radiologists report working an average of 49.6 hours a week.
- 90% of radiologists say they would choose their specialty again, ranking #10.
On the positive side, physician salaries continue to rise, and medicine is making encouraging progress in narrowing the gender gap. Radiologists seem to be well-compensated and relatively happy, but the specialty has more to do to attract women.
Underlying the raw data is a disturbing undercurrent of physician dissatisfaction, with many feeling as though medicine is a golden cage. In the free-response portion of the survey, doctors described themselves as caught between falling reimbursement and rising costs, with overwork also leading to burnout.
The Medscape survey shows that addressing physician burnout must become a priority for the US healthcare system, and it can’t be solved merely by boosting salaries. Increasing the number of residency slots is a good first step (see below).
The latest news on physician salaries is out, and it’s not pretty. A new Doximity survey found that average physician pay declined 2.4% last year, compared to an increase of 3.8% in 2021. The drop was exacerbated by high inflation rates that took a bite out of physician salaries.
The Doximity report paints a picture of physicians beset by rising burnout, shortages, and a persistent gender pay gap. Doctors across multiple specialties report feeling more stressed even as wage growth has stalled.
To compile the 2022 data, Doximity got responses from 31,000 US physicians. There was a wide range of average annual compensation across medical specialties, with radiology landing at number 10 on the top 20 list, while nuclear medicine occupied the 20th spot:
- Radiation oncology: $547k vs. $544k in 2021
- Radiology: $504k vs. $495k
- Nuclear medicine: $392k vs. $399k
In other findings of the report:
- Male physicians made $110,000 more than women doctors. At a gap of 26%, this is actually an improvement compared to 28% in 2021.
- Men physicians over their career make over $2 million more than women.
- Nuclear medicine had the smallest pay gap ($394k vs. $382k)
- The pay gap could contribute to higher burnout rates, with 92% of women reporting overwork compared to 83% of men.
- Two-thirds of physicians are considering an employment change due to overwork.
Ironically, Doximity cited results of a recent survey in which 71% of physicians said they would accept lower compensation for better work-life balance.
The news about salaries could be a gut punch to many physicians, who are already dealing with epidemic levels of burnout. Radiology salaries bucked the trend by rising 1.6%, which could explain its popularity among medical students over the last three years.
The question remains, is the money worth it? Rising imaging volumes have been tied to burnout in radiology, and the Doximity report indicates that some physicians are willing to forgo money for better quality of life.