Physicians remain among the highest-paid professionals in the U.S., but salary alone may be a poor measure of whether they feel fairly compensated.
From uncompensated administrative work and rising practice expenses to outdated salary benchmarks and payment models, physicians have little control over, four physician leaders told Becker’s the real compensation problem runs deeper than the size of a paycheck.
Editor’s note: Responses have been lightly edited for clarity and length.
Question: Does the average physician salary cover one’s needs and expenses in 2026?
Mary Coan, MD, PhD. Owner of Integrative Family Care at The Springs (Clifton Springs, N.Y.): Independent doctors are a dying breed. We don’t get a salary, we are not allowed to negotiate what the insurers pay us, and we get less than half what an employed doctor gets for the same service.
The insurance companies — Medicare included — play games with “coding.” There are always new codes, old codes and modifiers. If you aren’t up to date for the current coding rules, your claim for payment will be denied. We are told we are denied because it’s the wrong code, but they say they cannot tell us the correct code. We need to find the answer on the website. Navigating through insurers websites is a nightmare. It is almost impossible to find the right code and rebill it in the proper time frame. The time we spend trying to do this correctly is of course not paid, nor is the time we spend reviewing labs, documents, other doctors notes, etc. Most of us are leaving because we cannot get everything done in a timely fashion to have a life outside of work, and our expenses keep going up many times faster than what we get paid. The saddest part is that independent doctors have left the big healthcare systems because we want to be able to spend the time to understand a patient’s needs, their lifestyle and clearly explain to them how their health fits in. If anyone sees a solution, share it with us all. Please.
Robert Highland, MD. Physician Owner at Catawba Women’s Center (Hickory, N.C.): Honestly, most physicians are well paid, and I do not think we should pretend otherwise. For most, the average salary provides a comfortable living. But being well paid and feeling fairly compensated are not necessarily the same thing.
Physicians train for many years, often take on substantial debt, work long and unpredictable hours, and carry responsibilities that do not end when the office closes. Increasingly, they also spend a significant part of their day on documentation, prior authorizations, inbox messages and other administrative work.
I am not sure the answer is simply to pay every physician more. Fair compensation means recognizing the work physicians actually do — including the thinking, communication, care coordination and clinical responsibility — not just the number of patients seen or procedures performed. It also means adequate staffing, less meaningless administrative work, reasonable schedules and a compensation system that does not require physicians to sacrifice their own well-being to remain productive.
Narasimhan Jagannathan, MD. Professor and Division Chief of Anesthesiology at the University of Arizona College of Medicine (Phoenix): I am not sure that an “average physician salary” is particularly meaningful because the physician workforce is extraordinarily heterogeneous. Compensation needs and market pressures vary significantly by specialty, geography, workload, call burden, training requirements and the supply and demand for a particular specialty. Fields experiencing significant workforce shortages, such as anesthesiology, may require compensation strategies that respond much more rapidly to the external market.
Another challenge is that traditional physician compensation surveys often lag the actual market by a year or more. Fields experiencing significant workforce shortages or intense recruitment pressure, such as anesthesiology, psychiatry, radiology, OB-GYN and primary care, may require compensation strategies that respond much more rapidly to the external market. In these rapidly changing markets, relying solely on historical survey data can underestimate current recruitment and retention pressures. Health systems need to be more nimble and supplement national salary surveys with real-time indicators such as recruitment difficulty, vacancy duration, competing offers, locum rates, signing bonuses, retention incentives, call compensation and changes in contract terms. Base salary is only one component of the overall market for physician talent.
More broadly, I think physicians feel fairly compensated when there is transparency, predictability, and a clear connection between their responsibilities and their compensation. Organizations should regularly benchmark compensation, but they also need to understand the current market rather than relying solely on historical salary surveys. Compensation decisions should incorporate real-time recruitment and retention pressures, workload, specialty-specific demand and the full value of the total rewards package.
Ultimately, feeling valued is not solely about increasing salary. It is also about physicians understanding how and why compensation decisions are made and having confidence that those decisions are equitable, responsive, and sufficiently nimble to reflect a rapidly changing physician labor market.
Grace Terrell, MD. Chief Medical Officer at IKS Health (Burr Ridge, Ill.): Physicians undergo four years of college, four years of medical school then three to nine years of residency and fellowship before they finish their training. So most reach middle age with little wealth accumulation despite incomes that are higher than nearly all other professionals. And most physicians coming out of training now have six-figure student loan debt, also. As a result of the resulting compression in maximum earning years, many physicians do experience financial difficulties that they are ill prepared to handle. In general the fees we are paid for our services are not controlled by us- they are either set by federal policy or negotiated on our behalf by the entities that employ us, such as large healthcare systems, who are negotiating from a perspective of overall system revenue. These systems may accept lower fees for physician services and operate the physician practices at a “loss” in their internal accounting models in exchange for higher facility fees. The [relative value unit] payment system further perverts the economics of physician payment due to its skewed and complex methodology. A final blow arises in regulatory policy that constrains health systems to pay physicians based upon ‘fair market value’ which is narrowly defined and self-referential to the RVU productivity system.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
