While you have basically the whole world’s support for becoming a doctor, the road to doing so is a long and bumpy one. It not only involves your schooling and residence expenses. You also have to pay to travel to your interviews across the country and for your credential updates. One thing that you’re probably concerned about is what kind of salary you will earn in the long run. You may also be wondering whether physician salaries will depend on your specialty or state that you end up in.

The short answer to both questions is yes. 

Physician Salary Differences in Specialties

Every specialty saw an increase in their salaries by about 20 percent between 2016 and 2019. Primary care saw slightly more of an increase by a point and a half. They are still not equal, however, most doctors are generally very satisfied with their salaries. 

The cardiovascular-also known as thoracic-and orthopedic departments remain among the top departments at an average of just over $526,000 and $587,000. Neurosurgery, however, is now at the top with just over $616,000.

Family medicine, pediatric care, diabetic care and endocrinology all remain at the bottom. How much primary care doctors make varies by state. It ranges between about $150,000 and $250,000. With diabetes and endocrinology doctors, their salary range depends on factors like education level, age, number of years that they’ve been in the field and what other kinds of certifications that they earn. For diabetes doctors, it ranges between about $84,000 and just over $112,000. For endocrinologists, it ranges from about $146,000-$272,000.

Salaries usually start to increase significantly once doctors reach their 40th birthdays. It’s less significant if you’re in Primary Care mostly due to efforts to close the competition gap between younger and more experienced doctors. Specialists also tend to see the most significant increases in general. 

Physician Salary Differences in States

Doctors in southern and midwestern states tend to earn more than those up north. Kentucky currently pays the highest at an average of $346,000. They currently have a lower than average cost of living as well. They jumped from being in sixth place in 2019. Tennessee follows in second place with an average of $338,000, also has a lower than average cost of living with no income tax. Florida follows in third place $333,000 with no income tax and a growing economy. The fact that it’s a tourist state is also helpful.

Boston remains one of the lowest salary areas at $173,000.

Differences Between Race and Gender

Unfortunately, there are still some wide wage gaps between races and gender. On October 1, 2020, The New England Journal of Medicine published an article titled, “Physician Work Hours and Gender Pay Gap-Evidence from Primary Care”. They found that as of 2017, there was an significant gap with female primary care physicians earning almost 11 percent less than male primary care physicians. Up to this point, this has mainly been attributed to female physicians generally putting in less hours and receiving about nine percent fewer visits than their male counterparts. 

Female physicians tend to provide more direct care per visit, per day and per year. They also tend to spend more time on paperwork and clerical tasks. They tend to go into the lower paying fields, such as pediatric and primary care, in the first place. 

Men tend to prefer the higher paying fields such as orthopedics and plastic surgery. The only exception is the obstetrician/gynecologist field, which is just over 60 percent female. Their salaries vary by state ranging from just over $208,000 to just over $286,000. 

In April 2019, Jamie Ducharme in Time Magazine published an article saying that salary gaps between both gender and race. The gap between gender rose at about 25 percent. The average male physician’s salary was about $287,000 while the average female physician’s was about $207,000. With specialists, that gap was wider with the average male specialist’s salary being a whopping $372,000 and the average female specialist’s being only $280,000.

Between the races, white physicians currently have an average salary of $319,000, Latino doctors average $303,000, Asian doctors about $300,000 and Black doctors about $281,000. Ducharme says that implicit bias is probably the main culprit behind that. Implicit bias is a prejudice or a stereotype that the individual has but is not aware that it is a stereotype or prejudice. In the case of the physicians’ salary gap between both the genders and races, it may be influencing the amount of productivity. 

What about Branching into Entrepreneurship?

If that’s want you want to do, more power to you. The most successful entrepreneur physicians average an annual salary of $359,000 compared to those who work in hospitals and clinics with $289,000. However, please educate yourself about entrepreneurship first.

Like with any entrepreneurial endeavor, running your own clinic is not without it’s risks. For starters, unless you live in the same place that you work, a third to a half of what you earn will need to go to business utilities. You will also need to determine the costs of your equipment and that of staying updated with it as well as staying updated on your credentials. How successful your business will be will depend on those factors along with your patients’ continual satisfaction and trust.

What About Loan Forgiveness Programs?

There are several different kinds of loan forgiveness programs. However, they require certain work collaterals and other qualifications. 

  • Public Service Loan Forgiveness requires that you complete your residency in a participating nonprofit or public hospital. They also require you to have spent at least 10 years paying off your loans as they will forgive only what remains after that.
  • Most state loan repayment programs will repay all or some of your loans if you agree to work in an underserved or rural area for at least two years. You can learn more through the Association of American Medical Colleges database.
  • The National Health Service Corps Substance Use Disorder Workforce Loan Repayment Program offers repayments of up to $75,000 if you work in a participating detoxification center. If you have DATA 2000, you get priority if you are licensed to prescribe medications for opioid abuse, specialize in opioid treatment or are licensed in substance abuse intervention.
  • If you’re serving or have recently served in the military, you can contact your branch for loan repayment options.
  • If you choose to work with Native Americans or Alaskan Natives, the Indian Service Health Loan Repayment program offers up to $40,000 in student loan repayments. That one is taxable but the program pays a certain percentage of that. Any loans that you consolidate or refinance with someone else’s loans also don’t qualify.

As for those working in the COVID-19 frontlines, legislation currently has the Student Loan Forgiveness for Frontline Health Workers Act on the table but have not yet voted to pass it. If it passes, it will forgive those medical professionals’ entire loan balances.

COVID-19’s Impact on Physician Salaries

While most every other field has been impacted the opposite way, physician salaries have generally increased again. Average primary care physicians salaries increased from $237,000 in 2019 to $243,000. Specialists’ salaries jumped from $341,000 to $346,000. About half received a bonus of up to 13 percent depending on their specialties. Orthopedics has jumped up to about $511,000 while pediatrics and preventative health has remained tied at $232,000. 

As far as the gender gap is concerned, it has remained the same at 25 percent between primary care physicians. However, it has slightly decreased in the specialties with male specialists earning 31 percent, down from 33 percent more than female specialists. In the long run, however, it is predicted that the economic impact of COVID-19 will see budget cuts and decreases in the number patient visits. Some providers are already reporting a 55 percent drop in revenue and a 60 percent drop in patient visits.

About 43,000 healthcare workers were laid off in March. Even many emergency care physicians lost their contracts and/or had their hours and budgets cut. Patients using emergency services were often down by 40 percent or more. Others have faced cuts in night shifts or in shifts over all. 

According to Edwin Leap, MD (2020), even though physicians earn a lot compared to people in many other fields, at the end of the day, they have to spend a lot. Student loans and staying updated on the latest technological equipment aren’t the only issues. There’s also the credential updates. It can take up to a year to move from one location to another due to the constant updates in the state credentials. 

Dr. Leap advises students to first, try to come out of school with as little debt as possible. If you do have debt, think of it as service paid back to your field. Secondly, don’t buy big ticket items, such as a luxury house, immediately after graduation and residency completion. 

Physicians used to be able to get away with putting in more shifts per quarter. Though now that COVID-19 has made that difficult, taking on a side hustle or another part-time job may be practical.

Conclusion

Being a physician has long been associated with financial wealth. However, physician salaries actually vary by several factors, including state, specialty, gender and race. Neurosurgery is currently the highest earning field with just over $616,000 while pediatrics and preventative care currently tie for the lowest in the $250,000-$285,000 range. 

However, the COVID-19 restrictions have made significant impacts on everyone from those working in emergency services to specialists. This includes everything from cut backs on patient visits to bonuses. It is not yet certain as to how the medical field as a whole will be affected by it.