Over the holiday season, I was fortunate to spend time with family in northern California where I grew up. There I had the opportunity to catch up with some friends from high school. We talked about many things, but eventually the conversation turned to work, salaries and other practicalities of adult life we would have never guessed we would care about a decade ago.
“You’re going to be a surgeon?” one friend exclaimed. “Don’t forget about your ol’ buddy. You’re going to be so rich!” Reacting to the comment, I was unable to hide my indignation and amusement. “Man, if I chose to be a doctor for the money, I’d be well on my way to a deep and dark depression.” I went on to explain the realities of the matter. While the vast majority of American physicians are well-compensated financially, medicine is very rarely a path to great wealth.
According to the Medscape Physician Compensation Report in 2018, the average physician salary was $299,000.1 This annual income varies extensively based on many factors, including medical specialty, location and practice environment (e.g., a small private practice physician typically has a higher salary than an academic physician does). Regardless, taken as a whole this aforementioned salary places the average American physician squarely in the upper socioeconomic class.
Medical Education and Debt
Medicine attracts some of the best and brightest students in the country, young minds who could certainly land lucrative high-powered jobs on Wall Street or in Silicon Valley with less schooling and a quicker return on investment. There is a tremendous cost in dedicating the entirety of young adult life to medical education, which requires four years of college, four years of medical school, three to seven years of residency, and sometimes even a fellowship.
In medical school, instead of earning a salary and putting money away in an interest-accruing savings account, the average medical student graduates with $192,000 in debt.8 In residency, where salaries average $50,000 to $70,000 for grueling 80-hour workweeks, a hearty portion of this income must be dedicated to debt repayment. Notably, this training pathway is both longer and significantly costlier compared with other countries. Internationally, the cost of medical school is often free, and most students begin medical school immediately after high school, completing training and commanding a full physician salary at a younger age.
Putting this in perspective another way, how much does it pay to act like a doctor? Ellen Pompeo, known for her role as lead actress in the popular medical drama Grey’s Anatomy, earns more than $20 million a year. That is more than 66 times the salary of the average physician.
Are Physician Salaries to Blame for High Health Care Costs?
Physician compensation in the United States is hypothesized to be in the top five in the world, with the caveat that few large international studies on physician compensation have been conducted, and comparisons between countries are fraught with confounders.2 Given that the U.S. spends about twice as much per person on health than any other country (translating to a whopping 17 percent of its GDP), some have pointed to physician compensation as part of the problem behind the disproportionate cost of health care in America.3,4,5
While physician salaries are indeed part of the cost equation in health care, this equation is incredibly complex and multifactorial. Cutting doctors’ take-home pay would do little to solve the health care cost crisis.6 As economist and Princeton professor Uwe Reinhardt explained in a New York Times editorial, instead of comparing “the incomes of American physicians with those earned by doctors in other countries, a more relevant benchmark, however, would seem to be the earnings of the American talent pool from which American doctors must be recruited.”
The Joy of Medicine
If we do not continue to incentivize America’s best and brightest students to pursue medical careers, committing to years of hard work and delayed gratification, the health care crisis will continue to worsen. Health, much like education, is a foundational pillar of society, and its practitioners should therefore be motivated and remunerated in accordance with this responsibility. (Don’t even get me started on the undercompensation and underappreciation of teachers!)
Medicine is a challenging and arduous career. The joys of doctoring that initially motivate people to become physicians are becoming more difficult to fulfil in today’s practice environment. Yet, I am hopeful the prospect of being a physician will continue to attract talented young minds.
Medicine was never about “the money.” It is not about living a comfortable and lavish life. It is about a love of learning and a curiosity about the inner workings of the human body. It is about the rewards of sacrifice and the deep fulfilment of helping another human being. After all, medicine is not a career — it’s a vocation; it’s a calling.
- Physician Compensation Worldwide
- How does health spending in the U.S. compare to other countries?
- Health Care Spending in the United States and Other High-Income Countries
- The problem of doctors’ salaries
- Debunking Myths: Physicians' Incomes Are Too High and They Are the Cause of Rising Health Care Costs
- What Doctors Make, and Why (6 Letters)
- An Exploration of the Recent Decline in the Percentage of U.S. Medical School Graduates With Education Debt