10 Reasons Why Some Doctors Earn More (Even in the Same Specialty)

Leigh Page


August 12, 2019

Editor's Note: This article has been updated since its original publication on June 7, 2017.

It's not uncommon for physicians to wonder why some colleagues or physician friends seem to have so much more money. Although some doctors may just be more flamboyant spenders, others are probably earning a higher income.

Still, as one physician commented, "I look around at what some of my colleagues have, and I'm thinking, 'What did I do wrong?'"

There are large differences in wealth and income among physicians, even those within the same specialty. Although the average internist income is $243,000, according to the 2019 Medscape Physician Compensation Report, the range spans about $177,000 to $309,000 or more.

For instance, while 39% of family physicians had a net worth of less than $500,000, 16% of them had a net worth of $2 million or more in the 2019 Medscape Physician Wealth and Debt Report.[1] Age and gender differences can explain part of this wealth gap, and spending habits play a role, too, but there are other factors as well.

These 10 reasons may help explain why some doctors earn more than others.

1. Your Reputation or Status Attracts Patients, Donors, or Investors

Employed doctors can still earn multimillion-dollar salaries, but these riches are only doled out to superstar clinicians—the "rainmakers"—who can bring wealth to the hospitals and health systems where they work.

These doctors are expected to burnish the organization's reputation and bring a whole new stream of patients with them, says Travis Singleton, a senior vice president at Merritt Hawkins, a healthcare recruiter.

"The rainmakers are going to be treated differently from the average employed physician," he says. "They can get very generous compensation packages, but they are expected to work very hard."

Of the top 25 highest-paid physicians at nonprofit organizations, 15 were not the CEOs of their organizations, according to a 2015 analysis of federal income tax data by Modern Healthcare.[2]

An orthopedic surgeon in Ohio, for example, earned $2.8 million, whereas the system's CEO made $921,205, the magazine reported. In total, 496 physicians at these organizations earned more than $1 million a year.

The rainmakers are concentrated in a few high-earning specialties, such as orthopedics, neurosurgery, invasive cardiology, ophthalmology, radiology, oncology, and dermatology, Singleton says.

In 2017, for example, 15 doctors at Rutgers University in New Jersey earned more than $1 million, with the highest paid doctor, a neurosurgeon, earning $2.9 million.[3]

Several rungs down the payment ladder, young physicians who show potential for bringing in more patients can win generous signing bonuses. The average 2017 signing bonus was almost $30,000, an all-time high, whereas the highest was $200,000, according to the Medicus Firm, a healthcare recruiter.[4]


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