2024 surgery salary report: Trends, challenges in a changing landscape
January 13, 2025)
The 2024 Medscape physician compensation report highlights an overall upward trend in pay for most U.S. physicians in 2023, despite some top earners — including orthopedic and plastic surgeons — seeing declines.
Despite overall gains, inflation undercut physician satisfaction with take-home pay. Further, cumbersome regulations and administrative duties continue to create discontentment, causing physicians to question whether the salary outweighs the stress and sacrifices of the profession.
Read on to see how surgical specialties — including orthopedic surgeons, plastic surgeons, and general surgeons — fared in the 2023 analysis.
Average annual compensation
Average annual compensation dipped for orthopedic surgeons ($558k in 2023 compared to $573k in 2022) and plastic surgeons ($536k in 2023 compared to $619k in 2022). Despite these losses, the two specialties continue to vie for the top earner spot — coming in at #1 and #2, respectively.
Generous incentive bonuses consistently contribute to orthopedists' overall income, while increasing demand for cosmetic procedures continues to bolster plastic surgeons' earnings.
General surgeons’ average overall earnings increased year-over-year from $412k in 2022 to $423k in 2023. This figure places general surgeons just above middle earners on the annual ranking.
How surgeon pay compares with select specialties
Surgeon sentiment regarding pay
Despite high earning potential, surgeons ranked in the lower half — and even the lowest third, in the case of orthopedic surgeons and plastic surgeons — of physicians regarding pay happiness and satisfaction. Forty-six percent of general surgeons, 44% of orthopedic surgeons, and 39% of plastic surgeons reported being happy with their pay.
When surveyed regarding the fairness of overall physician pay, surgeons overwhelmingly held the view that physicians are underpaid (75% of plastic surgeons, 72% of orthopedic surgeons, and 68% of general surgeons).
This is in sharp juxtaposition to a 2021 survey of the general population, among whom only 11% believe physicians are underpaid, and half believe physicians are paid the right amount.
Surgeons’ happiness with pay compared to other select specialties
However, surgeons are more temperate about their compensation — 46% of general surgeons, 44% of orthopedic surgeons, and 39% of plastic surgeons believe they are fairly compensated for their work.
Inflation is thought to play a significant role in the perception and satisfaction surrounding earnings — a view that is not isolated to the medical community. A recent poll of all US employees indicated that 80% feel their pay isn’t keeping pace with rising costs despite increased pay over the same period.
Impact of pay on specialty selection
More than 80% of physicians said prospective pay had little or no impact on selecting a specialty.
This trend is consistent with general surgeons (83%) and orthopedic surgeons (82%), who reported pay was at most a minor factor when specializing. At 77%, a somewhat smaller share of plastic surgeons held this view.
How much potential pay mattered in picking their specialty
Interestingly, when a similar question was posed to medical school residents, half of the residents and half of the individuals surveyed said prospective pay was an influential factor when selecting a specialty. This suggests a shift in the perception and influence of earnings throughout a physician’s career correlated with increased earnings over time.
Potential for incentive bonuses
More than half of the surgeons surveyed (61% of general surgeons, 53% of plastic surgeons, and 52% of orthopedic surgeons) said they were eligible for an incentive bonus.
Incentive plans vary by physician and specialty; most physicians report needing to work longer and harder to earn them.
Among the surgery specialties surveyed, orthopedic surgeons typically reported the highest bonuses ($102k). Their bonuses, as well as those of other specialists, outpace bonuses earned by primary care physicians.
Supplemental income
In recent years, 36-39% of physicians surveyed reported supplementing their income with extra work, most often in the medical field.
This figure is consistent with trends for general surgeons (36%) and plastic surgeons (33%), who report taking on extra work - including medical moonlighting, extra hours at work, and other medical-related work - to supplement their income.
Orthopedic surgeons outpaced the pack, with nearly half (49%) taking on extra work. This figure represents an 8% increase compared to 2022, when 41% of orthopedic surgeons reported supplementing their income with extra work.
Are surgeons taking extra work to boost their income?
For Dr. Blaine Cashmore, a general surgeon who works locum tenens, the experience offers professional growth and personal flexibility, with supplemental income as an added bonus.
“I enjoy seeing how things are done at other places, meeting new people, and exploring whether the grass is greener on the other side without committing to a full job change,” says Dr. Cashmore. “The supplemental income is a bonus — I think it is a way to splurge on something we hadn’t planned without second-guessing. It’s nice to say, ‘let’s do it,’ because there’s extra money.”
The most rewarding, most challenging aspects of the job
Across surgical specialties, physicians surveyed cited being good at their jobs and gratitude from patients as the most rewarding aspects of their jobs. Making the world a better place is also highly ranked for general and orthopedic surgeons.
Most rewarding aspects of select surgical specialties
Orthopedic surgeon, Dr. David Hubler's experience with locum tenens, has given him a unique opportunity to connect with patients and experience their gratitude on an even deeper level.
“Locum tenens fills a definite need, and you can feel that when you go into these hospitals and clinics, and you can feel such appreciation from the staff and patients,” says Dr. Hubler. “It’s even more appreciation than I felt when working full-time in one location.”
Locum tenens fills a definite need, and you can feel that when you go into these hospitals and clinics, and you can feel such appreciation from the staff and patients.
Regarding the most challenging aspects of their jobs, general surgeons and orthopedic surgeons cited reimbursement challenges with insurers and cumbersome rules and regulations; for plastic surgeons, dealing with difficult patients and worrying about being sued top the list of job-related concerns.
Many physicians in the survey pointed to the growing corporatization of medicine as a significant challenge, highlighting frustrations with nonmedical personnel influencing clinical decisions and a system focused more on quantity than quality of care.
This growing administrative burden was a key reason Dr. Hubler turned to locum tenens, seeing it as an opportunity to alleviate the nonclinical demands of private practice.
“I was in private practice for 29 years, and it got to the point where I would work until 5-5:30 seeing patients, but it would be 8:30 or 9:00 by the time I finished up all the computer work and paperwork for the insurance companies and the government and taking care of the office and everything in general,” says Dr. Hubler. “Locums simplified a lot of that. Yes, we have some computer work and paperwork, but it’s not nearly what it is in operating my own office.”
Surgeons are in high demand as locum tenens. Give us a call at 800.453.3030 or view today’s physician job openings to get started.
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