As he took me through an interactive map on his computer screen, Oakland physician Nate Gross showed me what a neurosurgeon in my area might expect to make. Scrolling his cursor over the D.C. suburb of Montgomery County, Maryland, a number appeared: $580,000. I knew that, vaguely, but I did gasp.
"But if you move down to South Carolina," Gross continued, scrolling south, "here, you're looking at $645,000."
In an even more drastic example, the average anesthesiologist practicing in Massachusetts would increase her salary by 61 percent if she moved to Wisconsin. Most doctors have a vague idea that they could earn more money if they moved away from big cities and the coasts, where job markets tend to saturate—or if they abandoned preventive care to specialize in anything involving a scalpel or lasers. But in a profession where talk of finances is taboo, job listings rarely include salaries, and compensation models are duly withheld from medical-school curricula. Today Gross's company, Doximity, launched a new tool that lets doctors see exactly what salaries other doctors are earning, by county and specialty. The maps already include anonymous data from more than 18,000 physicians.
"The goal here is to empower doctors with transparency," said Gross. "They're going to be looking for jobs after residency, and they have no idea what they're doing. They weren't taught that kind of stuff in residency. They were taught how to be doctors and surgeons." And in the job search, "They don't necessarily get screwed over, but they don't necessarily get what they deserve, either."
Gross is a co-founder of Doximity, a social network for physicians that is growing quickly, now claiming more than 400,000 members. He described the site as LinkedIn for doctors. (LinkedIn is apparently cool enough now that some startups are intentionally invoking with it.) In recent years Doximity has become a Rolodex and reference platform for doctors. Now it's trying to be a Glassdoor, too, helping physicians find jobs and understand markets.
Here, for example, are Doximity's average salary numbers by specialty. These data are valuable almost exclusively in a relative way, showing what the U.S. healthcare model tends to value most, and partly explain why there is an ongoing shortage of primary-care doctors. While similar salary breakdowns have been published by Forbes, Medscape, and Merritt Hawkins, among others, Doximity's numbers are based on the most comprehensive approach yet.
Average U.S. Physician Salaries by Specialty
|Allergy and Immunology||$296,705|
|Colon and Rectal Surgery||$343,277|
|Obstetrics & Gynecology||$315,295|
|Pediatric Emergency Medicine||$273,683|
|Pediatric Hematology & Oncology||$192,855|
|Pediatric Infectious Disease||$163,658|
Caveats and context: The data are averages of individual and group practices, private practices where a doctor sees many, many patients, and academic institutions where a doctor might spend a majority of her time on research and teaching. The physicians who contributed to this data were, on average, between 20 and 30 years removed from medical school. These salaries do not begin until a decade or so after the doctor graduates from college: All physicians spend four years in medical school (emerging with an average debt of around $170,000), and then spend three to eight years in residency and fellowship programs where they are earning salaries of $51,000 to $66,000, and often working schedules that are all-consuming, temporally and existentially. The data do not include costs like malpractice insurance, which vary widely by specialty and location and nature of practice, or performance bonuses.
They also do not include the value of the smile on a patient's face, which is worth infinity dollars (pretax).
Yesterday I talked with Eric Topol, a cardiologist and director of the Scripps Translational Science Institute (also described by GQ as a "rock star of science"!) whose latest book The Patient Will See You Now describes the imminent incorporation of massive health-data systems into medical science. Being a doctor, in his view, will become less about ordering tests and more about reacting to a constant stream of data about all aspects of a person's life—empathizing and guiding as a smart phone gives a person daily numeric health feedback. Medicine stands to become more collaborative and transparent at every level. Physician employment dynamics are apparently not immune.