Physicians are earning more, but the system is failing them

Physician pay increased 3.7% from 2023 to 2024, according to Doximity’s 2025 Physician Compensation Report. While any increase might appear encouraging, the report paints a more sobering picture — modest gains amid inflation, a widening gender pay gap, mounting concerns about Medicare and Medicaid reimbursement and growing financial strains among pediatricians.

The report, released July 31, compiles data from more than 37,000 full-time physician responses in 2024, and over 230,000 responses over the last six years.

Doximity, which claims over 80% of U.S. physicians as members, emphasized that the findings reflect a health care workforce that feels overworked, under-compensated and increasingly uncertain about the future.

Reimbursement pressures hit pediatric care hardest

A separate June 2025 survey of more than 1,200 pediatricians and pediatric sub-specialists revealed broad concern over payment adequacy.

Nearly 90% of respondents said current reimbursement doesn’t align with the complexity of pediatric care. Half reported that low reimbursement has already limited their ability to provide care, and 37% said they fear it could in the near future.

The disparities between pediatric and adult specialties are significant. Adult hematologists and oncologists earned 93% more than their pediatric counterparts. Gastroenterology showed an 80% pay gap. Cardiologists, pulmonologists and rheumatologists also saw significant divides.

These gaps have real-world consequences: 65% of pediatric specialists said they’ve had to change their practice model — cutting services, increasing patient loads or reducing staff. More than two-thirds said lower compensation has prompted thoughts of leaving the field altogether.

The gender pay gap

After narrowing slightly in 2023, the gender pay gap widened again.

In 2024, average physician compensation rose 5.7% for men, compared to just 1.7% for women. As a result, women physicians earned $120,917 less on average than men, even after adjusting for specialty, experience and geography.

The gap persisted across all specialties. Pediatric nephrology, which reported the highest annual pay growth in 2024 (15.6%), also had the largest gender pay gap.

Independent practice continues decline

Eight in 10 physicians surveyed agreed that reimbursement policy is a significant driver of the decline in private practice. According to the American Medical Association (AMA), the share of physicians working in private practice fell from 60.1% in 2012 to 42.2% in 2024. Among those surveyed by Doximity, nearly one-third had already reduced, or planned to reduce, the number of Medicare or Medicaid patients they serve.

More than one-third of respondents said they had delayed hiring or expanding services due to reimbursement concerns. Despite demand for care, 89% said the physician shortage is already affecting their clinical practice.

Burnout, overwork and career changes

Burnout continues to take a toll. In Doximity polls from May and June 2025, 85% of physicians reported feeling overworked. Nearly 70% said they were considering a career change or early retirement. Among primary care physicians, 90% said they felt overworked, more than any other specialty.

As a result, physicians are increasingly prioritizing autonomy and balance — 77% said they would accept lower pay in exchange for a better work-life balance. That trend has grown each year since 2023.

Primary care is in high demand, but still underpaid

Primary care specialties — including internal medicine, family medicine and pediatrics — remained among the most in-demand in 2024. They also remained among the lowest paid.

Surgical specialists earned 87% more on average than primary care physicians, though the gap has narrowed from 100% in 2022.

Despite that, many primary care physicians are looking toward more flexible work models, including locum tenens roles, which saw a surge in interest this year. Internal medicine and family medicine topped the list of most in-demand locum specialties.

The report underscores a central contradiction in U.S. medicine: physicians are needed more than ever but feel increasingly unable to meet that need.

As reimbursement cuts and workforce shortages continue to squeeze practices, especially in pediatrics and primary care, the question becomes not whether physicians are committed to their work — but whether the system is committed to them.