Medscape's Physician Compensation survey 2015 included questions on physician debt and net worth. While earnings are related to net worth, debt, spending habits, expenses, and investments also play a huge role. Physicians also gave us some intriguing information about their investment mistakes.

Physicians provided their compensation for patient care. For employed physicians, patient-care compensation includes salary, bonus, and profit-sharing contributions. For partners, this includes earnings after taxes and deductible business expenses but before income tax. According to this year's Medscape survey, orthopedists made the most ($421,000) and pediatricians and family physicians made the least ($189,000 and $195,000, respectively). Data from a major 2009 study suggested that PCPs earned a cumulative average lifetime income of about $6.5 million compared with over $10 million for specialists.^[1] Note: Values in the charts have been rounded.

Physicians estimated their net worth, defined as total assets (eg, money in bank accounts, investments, retirement accounts, home equity, value of cars, value of jewelry, etc.) minus total liabilities (eg, money owed on mortgage, car loans, credit card debt, school loans, home equity loans, etc.). Respondents chose 1 of 5 range categories:

1. Under $500,000
2. $500,000-$999,999
3. $1 million-$1,999,999
4. $2 million-$5 million
5. Over $5 million

The chart shows the percentages for each specialty and their average category value. It comes as little surprise that net worth generally followed a pattern similar to that of compensation. Respondents rated their net worth on a scale of 1 to 5 in the categories above; then the ratings were averaged within each specialty. At an average rating of 2.95, orthopedists had the highest net worth; at 1.95, family physicians had the lowest.

As one would expect, net worth improves over time. Over 90% of physicians younger than 28 years of age were worth less than $500,000. Net worth increased with age; by age 50, less than a quarter (23%) had a net worth under $500,000. By then, over half (55%) were worth $1 million or more. By age 65, nearly half (49%) had accumulated over $2 million.

According to a 2013 study, only 49% of American women had more savings than debt compared with 60% of American men.^[2] Female physicians not only make, on average, 24% less than male physicians, according to Medscape's 2015 Physician Compensation Report, but their net worth is also much lower. Nearly half (48%) of female physicians had a net worth of less than $500,000 compared with about one third (34%) of their male counterparts. Conversely, nearly half (48%) of men had a net worth of at least $1 million compared with one third (30%) of women. It should be noted, of course, that fewer women are in the higher-paid specialties. According to a 2012 report from the Association of American Medical Colleges (AAMC), the highest percentage of female physicians (58.1%) were in pediatrics (the lowest-paid specialty) and the lowest percentage (4.0%) were in orthopedic surgery (the highest-paid).^[3]

When looking at categories of debt and expenses, male and female physicians were similar, with one interesting difference: A higher percentage of women (35%) are still paying off their school debts compared with about 25% of men. This might be due to a higher proportion of younger to older female physicians. In a census study of physicians, two thirds (66%) of female physicians were 50 years old or younger compared with 44% of male physicians.^[4] There are no differences between men and women regarding whether or how much they borrow in school loans.^[5]

Well over a third (37%) of emergency physicians are still paying off their school loans, followed by intensivists (35%) and family physicians and dermatologists (both at 34%). Those least saddled with these debts are pulmonologists (16%) and gastroenterologists (17%). It is not possible to draw conclusions on why some specialists are more able to pay medical school debts. Slightly more than a quarter (26%) of orthopedists, who have both the highest earnings and highest net worth, still owe on these debts. This is the same percentage as internists and psychiatrists, who fall within the bottom seven for earnings and bottom three for net worth.

It is not surprising that the percentage of school debt falls steadily with age. According to the AAMC, medical school debt has increased by 6.3% since 1992 compared with a 2.5% increase in the Consumer Price Index.^[5] The AAMC also has reported that the median 4-year cost to attend medical school for the class of 2013 was $278,455 at private schools and $207,868 at public ones.^[6] Given these high tuitions, resident debt has risen much more rapidly than inflation or resident compensation. According to the Medscape survey, 20% of physicians 50 and older are still carrying this liability. Even more physicians may owe money on college in mid-life as the current younger group of physicians age, and their higher debt continues into later life.

The majority (61%) of physicians report that they live within their means, while nearly a quarter (24%) claim that they live below their means and that people would be surprised by how much money they make. Only 11% confess to being spendthrifts. In general, physicians do not feel "rich." In a 2012 Medscape survey, only about 11% of physicians overall said that they considered themselves rich, while 45% said that their income is no better than that of many nonphysicians. Another 45% said that although their income probably qualifies them as rich, they have so many debts and expenses that they don't feel rich.

Reportedly, women make more than 85% of the consumer purchases in the United States and reputedly influence over 95% of total goods and services purchased.^[7] The Medscape report, however, suggests that at least among physicians, the amount they spend compared with their means differs very little between men and women. Women do not spend more than men; but slightly fewer women (22%) live below their means compared with men (25%).

A 2010 Pew report followed the income disparities between husbands and wives from 1970, when only 4% of husbands made less than their wives, which rose to 22% in 2007.^[8] In the current Medscape survey report, almost two thirds (62%) of female physicians make either the same as or more than their partners. Over half of female physicians earn more than their significant other. Still, 63% of male physicians say that their significant other makes a lot less than they do, compared with 37% of women who reported having that situation.

Over three quarters (77%) of all physicians have not experienced any significant losses over the past year. Considering the flux in the healthcare environment, it was somewhat surprising that only 11% said they had lost large amounts because of practice changes or problems.

No differences were observed between men and women when asked about financial losses. In both genders, 77% experienced no significant loss.

Some variation was observed among specialists when they responded to the question on financial losses due to practice issues. Not very surprising, only 6% of intensivists and 7% of emergency medicine physicians—both hospital-based specialties—reported loss. Furthermore, very few primary care physicians (11% of family physicians, 9% of internists, and 8% of pediatricians) suffered recent financial losses. The specialists who were most disadvantaged by practice issues were urologists (21%), allergists (18%), plastic surgeons (18%), and orthopedists and ophthalmologists (17%).

Over half (55%) of physicians claimed to have never made an investment mistake. Others confessed to making errors in real estate (14%), stocks or businesses (28%), and other investments (14%). When looking at write-in responses, the most consistently reported mistakes focused on the tech bubble in the 1990s and the real estate crash in 2008. This is hardly surprising because there were three consecutive years of negative returns in the S&P 500 stock market index (from 2000 to 2002) and a crushing 37% drop in 2008.^[9]

When looking at bad investments by specialty, 40% of anesthesiologists reported that they had made bad choices in stock or business investments—the highest percentage among all physicians. Next in line for choosing unwisely in these areas were urologists and ophthalmologists (39%) and orthopedists and radiologists (37%). Twenty-two percent of orthopedists also did poorly in the real estate market, the highest percentage in this investment category. Nineteen percent of anesthesiologists also took a hit in real estate, followed by plastic surgeons and urologists (18%). These all tend to be higher-paid specialists, so they might have a higher likelihood to take more risks. The lower-paid physicians tended to report fewer investment mistakes.

Physicians who said they never made any investment mistakes tended to be those with lower earnings and net worth: 67% of endocrinologists, 65% of infectious disease physicians, 64% of pediatricians, 62% of neurologists, 61% of internists, and 60% of family physicians. It is possible that these physicians are much more conservative than their wealthier peers and tend not to take chances on risky ventures with their more limited resources.

This word cloud is a representation of approximately 15,000 write-in responses to a question asking physicians to specifically describe their investment mistakes. Bad stocks, real estate disasters, buying houses at the top of the market, bad advice, and the effects of the 2008 crash emerged as the major mishaps.