Physician Compensation Fell, Gender Pay Gap Persisted in 2022

Economic challenges for healthcare workers continued in 2022, as the average physician compensation fell by 2.4 percent and the gender pay gap persisted, according to a report from Doximity.

The report reflects responses from more than 190,000 US doctors over six years, with responses from 31,000 full-time physicians in 2022 alone.

While physician compensation declined by 2.4 percent overall between 2021 and 2022, changes varied in metro areas. Physicians in Oklahoma City experienced a 6.3 percent increase in compensation. Among the other nine cities with the highest increases, growth ranged from 1.1 percent to 4.6 percent.

Charlotte, North Carolina, had the highest average physician compensation at $430,890, while physicians in Washington, DC, had the lowest average salary at $342,139.

Across many specialties, compensation remained the same or declined in 2022. Emergency medicine physicians saw the highest increase in salary at 6.2 percent. Preventive medicine appeared in the top 10 specialties with the largest compensation increase, although the growth rate declined from 12.6 percent in 2021 to 4 percent in 2022.

Neurosurgery ($788,313), thoracic surgery ($706,775), and orthopedic surgery physicians ($624,043) had the top three highest annual compensations in 2022. On the other end, pediatric endocrinology ($218,266), pediatric infectious disease ($221,126), and pediatric rheumatology physicians ($226,186) had the top three lowest compensations.

Compensation growth varied by employment setting. For example, single specialty groups (-0.7 percent), multispecialty groups (-0.7 percent), and urgent care centers (-1 percent) saw compensation reductions in 2022. Meanwhile, solo practices (3 percent), health systems (1.4 percent), and health maintenance organizations (3.4 percent) saw increases in compensation.

The gender pay gap for physicians was significant, despite falling 2 percent from 28 percent in 2021 to 26 percent in 2022. Women physicians earned almost $110,000 less than men physicians, even when controlling for specialty, location, and years of experience, the report found.

There was no specialty in which women earned the same or more than men. The gender pay gap was over 10 percent for all specialties except pediatric cardiology (9.2 percent) and nuclear medicine (3 percent).

Physician demand remained high in 2022. Tallahassee, Florida, and Springfield, Illinois, were the two metro areas with the highest physician demand. These cities were also the top two areas with the highest demand for locum tenens physicians.

Family medicine, psychiatry, and internal medicine were the most recruited specialties last year, indicating significant demand within these specialties.

In addition to lower pay, physicians are feeling overworked and experiencing burnout. Two-thirds of physicians said they are considering an employment change, whether it be looking for another employer, early retirement, or changing careers entirely.

Women face heavier burdens than their male counterparts, with just 8 percent of women physicians saying they are not overworked, compared to 17 percent of men physicians.

Physician salaries did not keep pace with the 9.1 percent inflation rate in 2022. Physicians are also facing a 2 percent reimbursement cut this year.

In its recent report to Congress, the Medicare Payment Advisory Commission (MedPAC) urged lawmakers to update the 2023 Medicare base payment rates for physicians and other healthcare professionals by 50 percent of the expected increase in the Medicare Economic Index (MEI). This would translate to a 1.45 percent increase.