Doctor Salaries by Specialty for 2022-2023: The Highest and Lowest Paying Jobs

There are nearly 100 specialties in which doctors can practice medicine, and they vary widely in the amount they pay their practitioners. When choosing a specialty you can't let the finances cloud your overall judgement, however being naïve about the payment structures can prevent you from living up to your financial goals. Don't get me wrong, you will no doubt be in a comfortable financial situation as a physician, however some specialties may take much longer to pay off student loans, and afford you that vacation home you've always dreamed about! On the low-end of the spectrum you can expect an average of $221,000 a year and on the high-end upwards of $526,000 a year. Some workaholics have the potential to make even more with rumors of some specialists pulling in over $1.5 million a year, however I do realize this is anecdotal evidence.

Overview:

• Average Doctor Salary

• Intra versus Inter-specialty Pay

• Highest-Paying Doctor Salaries

• Lowest-Paying Doctor Salaries

• Location, Location, Location, Location

• Specialties with Rising Starting Salaries

• Supplemental Your Income

Average Doctor Salary:

Who cares, right? As we have already alluded, the national physician salary average is of little utility considering the wide range of specialties that get grouped together. If you where to factor in an interventional cardiologist's $600,000/year salary and compare it to an infectious disease specialist's salary of $250,000/year we would get an average salary of $425,000! Pretty far off from what each is actually making.

Intra versus Inter-specialty pay:

Widespread differences in pay across specialties isn't the only variable at play. We also see large variations salary across a single specialty. Much of this discrepancy can be attributed to location across the country (including cost-of-living factors), as well as the hours worked. It should be relatively obvious that doctors that choose to work longer hours will subsequently generate higher incomes. This follows the classic "eat what you kill" philosophy. The Anesthesiologist who elects to pick-up 10 call shifts a month is going to make substantially more than their passive government-employed counterpart who spends more time perfecting their golf game than actually sitting in the OR. The example below may be oversimplified (gross pay, not net take-home) but you can quickly see how Anesthesiologist #1 might have a very different salary from Anesthesiologist #2. This same principle applies for all specialties! Also, don't forget about the potential to make additional income or bonuses through RVU payments. While not every physician will have access to this, it may be something important to address prior to signing a contract.

Source: Salary.com

Highest-Paying Doctor Salaries:

Finding specialty salaries is typically the easy part, but finding hourly wages that match the expected hours worked is the real challenge. The following infographics include a variation of top-physician salaries to help you gauge what you can expect across specialties.

Physician Staffing: Merritt Hawkins

I liked the data above provided by Merritt Hawkins because it makes distinctions across cardiology (being interventionalist and non-interventionalists) and includes CRNA pay. With that said, it's neglects to mention other high-paying specialties such as ENT, General Surgery, and Plastic Surgery. The Medscape Survey data below helps summarize this data.

Medscape Physician Salary Survey 2022

This final infographic below also addresses other higher-paying surgical specialties (Neurosurgery, Cardiothoracic Surgery) that historically claim the highest income across the board! As mentioned, these salaries can wax and wane several hundred-thousand dollars based on the particular contract you have with your employer and the hours you put in!

Lowest-Paying Doctor Salaries:

Now that we've addressed the highest paying specialties, let's take a look at the lowest paying. Keep in mind that as a pharmacist with a larger baseline loan-burden and salary opportunity cost, you may want to do some additional analysis to determine your return on investment. What I am referring to is your "break-even" point at which the added cost of attending medical school (4 years of tuition ~$250,000) along with your school + residency training opportunity cost ($100,000 pharmacist salary x 7 years minimum). At baseline, choosing to go to medical school puts you close to a Million behind! Choosing a lower paying specialty will take much longer to recoup the lost income and this factor should be considered (obviously secondary to following your passion).

Location, Location, Location, Location:

Another factor that can help you estimate your future attending salary is your intended location of employment. Finding a high paying physician salary is highly dependent on the region you are hoping to live in. Your specialties' average salary can vary dramatically if you are planning on working in a large saturated city (New York City) or out in a rural community. The particular scarcity of your position in combination with the demand for the service directly impacts your potential income!

State-based income tax is also a very important feature to consider! Living and working in a low or no income tax state can help you keep an additional 7-10% of your annual salary. Use this calculator to help assess how much you will lose in State and Federal Taxes annually! Now this is also assuming that you are NOT effectively lowering your taxable income which can lower your overall tax bracket (a topic for another day).

Specialties with Rising Starting Salaries:

The specialties listed below are what you might consider the "hot" jobs on the market which have seen a significant rise in annual salary growth. The mentioned percentage rises are based on a national survey comparing the starting salaries from 2021 to 2022.

1. Obstetrics & Gynecology: +14%

2. Radiologist: +12%

3. Anesthesiologist: +8%

4. Gastroenterologist: +7%

5. Neurologist: +7%

6. Psychiatry: +7%

Supplementing Your Income:

There is a foundational difference between working out of "financial necessity" and working because you "choose to." Physician's have the unique opportunity as high-income earners to invest in various avenues that can supplement your working-hour income. Most doctors are by definition "rich" when comparing salaries to the average American, however few are actually "wealthy." What I am referring to is the creation of alternative methods to supplement your worked income. As "Rich Dad Poor Dad" puts it; wealthy individuals make their money work for them! Investopedia also refers to the physician cohort as HENRYs (High Earners, Not Rich Yet). HENRYs are defined as families earning between $250,000 and $500,000, but not having much left after taxes, schooling, housing, and family costs—not to mention saving for an affluent retirement.

One way to make your financial headache disappear is to lower your cost of living, or at least deferring your lavish sports car purchase until you have a stronger financial footing (ie. Paying off loans, purchasing assets such as rental properties, etc.). The White Coat Investor refers to this phenomenon as "Lifestyle Creep" which can be fatal to some of our less financially savvy healthcare professionals. Sure, you might take home a substantial monthly allowance, but you realistically have few dollars left over after your massive mortgage and sports car payment show up on your tab. Are you really wealthy or a victim of financial entrapment who cannot quit their job lest you face financial ruin.

So how can physicians make their money work for them? The basic financial option involves maxing out your retirement contributions (especially if there is an employer match), lowering your taxable income by parking funds in health savings accounts or other financial vehicles, and purchasing assets that generate monthly income instead of costing you money. This last category includes real-estate investing such a rental property procurement! Most banks offer Physician Mortgage Loans which can be a great way to purchase properties with little money down while avoiding costly PMI! For more information about basic financial decision making, check out the 4th Episode of The Physician Pharmacist Podcast where we interview a Professional Financial Advisor and licensed pharmacist, Dr. Tim Ulbrich!

Outside of prudent investing, smart spending, and diversification of assets, Physicians can also make more money through these other methods!

• Locum Tenens: Also known as a "travelling physician." Physicians who elect to participate in these contracts can expect approximately 20% higher wages than maintaining standard employment. By acting as a travelling physician you help understaffed hospitals in areas that may be undesirable stay afloat. The money can be excellent, and some contracts can be as short as a week! This is a popular option for those who like to travel and make some extra cash for the hours you work! The downsides include being away from family and potentially being cast into difficult work environments. This tends to be a more popular option for younger physicians!

• Medical Consulting: Your degree grants you the authority to speak on various medical topics and your advice and perspective can generate income. This can also start you along the path of business ventures where you can create a company or serve on a board of a corporation.

• Expert Witness: Using your medical background you can testify in court and get paid massive amounts of money (upwards of $500-1,000/hour)!

• Take on Administrative Roles: While answering emails and coordinating staff can add to your baseline stress level, you can make a few extra bucks taking on some of these tasks!

References:

1. How to Choose a Medical Specialty: A Pharmacist Perspective

2. The White Coat Investor: How Much Do Doctors Make

3. Health Grades: The Highest and Lowest Physician Salaries by Specialty

4. 7 Physician Side Gigs for Extra Income

5. Physician Starting Salaries by Specialty: 2022 vs. 2021

6. Smart Asset Federal Income Tax Calculator (2022)

7. Physician Salary Report 2022: Physician Income Rising Again

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