How much do doctors earn? Why it's America's highest-paying job.

Q: What are the 20 highest paying jobs in America?

Answer: Doctor.

It’s pretty much true: of the twenty American professions with the highest average wageAccording to the Bureau of Labor Statistics, 16 are a type of doctor.

As of 2023, pediatric surgeons will earn an average of $449,320 per year, according to federal data. Cardiologists earn $423,250. Orthopedic surgeons will receive $378,250.

Only four of the twenty highest-paid professions are not doctors. They’re dentists. (And orthodontists, dental surgeons and specialists.)

Doctors earn more than any other broad category of workers, according to federal data: more than engineers. More than computer scientists. Even more than that lawyers.

To find a better-paid group than doctors, economists say, you need to delve into subcategories of the elite, such as corporate CEOs and legal partners. The average partner at a large firm earns more than 1 million dollars per year. The typical CEO of the S&P 500 collected $16.3 million in 2023, according to the Associated Press.

American doctors are paid so remarkably well that a group of economics researchers spent years trying to figure out why.

Here’s what they found.

Lots of school, lots of hours

As any medical school applicant knows, becoming a doctor requires a very long period of study: first college, then medical school, and years of post-graduate residency training.

And the hours are long. A doctor’s typical work week ranges from 40 hours to 60 hours or more, the researchers found, depending on the specialty.

“It involves a lot of training and long working hours, and that is of course accompanied by higher earnings,” he says Joshua Gottlieban economist from the University of Chicago who was involved in the study.

Gottlieb and his colleagues found that physicians within the medical profession tend to earn more in specialties that require more training and longer hours. For example, each additional year of training translates into $143,000 in additional annual income.

But education and working hours don’t tell the whole story. Farmers and ranchers work long hoursaccording to an old federal report, and they don’t earn doctor’s fees.

As for training, many of Gottlieb’s own colleagues in academia spend as many years in school as physicians. And most professors earn less than $100,000 per year.

“My brother is an emergency room doctor, and I was in school longer than him,” he said Teresa Ghilarduccichairman of economics at The New School for Social Research in New York. She was not involved in Gottlieb’s investigation.

Doctors love money

Gottlieb and his co-authors were criticized by doctors for saying this, but their research found that doctors are seeking higher-paying jobs.

The average doctor earned $350,000 in 2017, the researchers reported in an article Working paper 2023which is awaiting publication in the Quarterly Journal of Economics. The top 1% of physicians earned more than $1.7 million per year.

Researchers found that doctors from the best medical schools are flocking to the highest-paying specialties. Doctors also prefer procedures that yield more profit.

Some medical specialties are blindingly well paid. Here are some 2017 top salaries for doctors in their peak earning years, ages 40 to 55, according to Gottlieb and his colleagues:

Neurosurgery: $920,500
Orthopedic surgery: $788,600
Dermatology: $655,200
Cardiac surgery: $607,300
Ophthalmology: $597,000

“We’re seeing people gravitate toward specialties where wages are rising,” Gottlieb said, just like salary-conscious workers in any field. “I think it’s the human way.”

Maria Polyakovaan associate professor at Stanford Medical School, joined Gottlieb in the study. She notes that medical graduates tend to be exceptional students with many career choices.

“For the most part, they are top students in the country who could have pursued other opportunities that paid just as well,” she said.

The American Medical Association noted in a statement to USA TODAY that physicians often spend 12 to 15 years in training, typically leaving medical school with more than $200,000 in debt. Higher salaries help them get out of debt and make up for years of missed work.

There are not enough doctors

The United States has fewer doctors per capita than most other developed countries, according to the Organization for Economic Co-operation and Development: 2.7 per 1,000 potential patients, as of 2021, compared to 3.4 in France and 4.5 in Germany.

A major reason, the researchers say, is that the medical industry and the federal government control the number of seats in U.S. medical schools and the number of residencies in hospitals.

The shortage comes from an era when healthcare industry leaders believed this was the case too many doctorsleading to enrollment ceilings in medical schools and residencies. Ironically, the same groups are now warning of one shortage of doctors.

The medical association says its evolving position reflects the evolving state of the industry, noting that the current crop of physicians is aging and dealing with burnout.

“We have a kind of artificially limited supply of doctors,” he said Andrew Biggsa senior fellow at the right-wing American Enterprise Institute, who was not involved in Gottlieb’s research. “That’s what economists call barriers to entry,” he said, and it drives up doctor salaries.

The American Medical Association is “acting like a union for doctors” by limiting their numbers, Biggs said. “The goal is to keep salaries high.”

The government sets the prices

A fundamental reason why doctors earn a lot is that medical care costs a lot, researchers say. And the federal government largely determines those prices.

Medicare, the federal insurance program, sets prices for medical services. Prices are high enough to cover health care expenditures minimum 17% of the country’s gross domestic product.

“The government has decided and the policy has decided to devote a very large portion of society’s resources to health care,” Gottlieb said.

Customers – patients – have little say in the costs of their medical care.

“It’s not like you’re going to compare surgeons’ prices,” Biggs said.

This setup, economists say, makes the health care sector almost unique among U.S. industries.

“In some ways the medical industry is like a defense contractor,” Ghilarducci said. “Their main customer,” the federal government, “has deep pockets.”