Physician compensation increasingly comes from a mixture of several factors—most often, a set salary with productivity and bonus metrics included—than it does one particular source, according to recently released data analysis by the AMA. The findings are especially relevant to residents and fellows who are transitioning to practice and need to understand the prevailing physician payment landscape as they evaluate job offers and negotiate their first physician contract.
These “blended” payment methods have moved from a simple majority to the bulk of physician compensation structures, according to a new AMA Policy Research Perspectives report. The analysis shows that 60.8% of physicians got their compensation from more than one method in 2024, compared with 51% in 2014. There were differences noticeable by physician gender, specialty and practice type.
“There’s more flexibility available and [physicians are] not taking the one-size-fits-all model that used to exist,” said Apoorva Igwe, PhD, economics director of health policy for the AMA and the study’s author. “In the old data, we'd see a lot more of only-this or only-that [type of compensation]. Whereas now, for any type of position—if you're a physician who’s a practice owner or an employee in a single specialty or multispecialty practice—there seems to be a certain level of flexibility of being able to get that stability in the salary, but also an upside in the productivity.”
The recent analysis found the prevalence of each physician compensation method has fluctuated. In 2024, for example, the data shows that 70.5% of physicians got at least some of their compensation from salary, a figure that represents a 9 percentage-point hike over 2014’s numbers. And in 2024, 55% of physicians said some of their compensation came from productivity metrics, up 2 percentage points from 2014. Additionally, 39% of physicians said they got at least some amount of compensation in bonuses, another 9 percentage-point jump.
The share of physicians reporting that more than half of their compensation is based on salary rose 10 percentage points from 2014 to 2024.
Conversely, the proportion of physicians who are paid solely based on productivity measures fell 5 percentage points in that 10-year period. Additionally, the share of physicians paid based entirely on practice financial performance also fell, 4 percentage points in that same time.
Of physician compensation, 58.2% came from salary, on average, and productivity, on average, contributed 28.1%.
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How the survey was conducted
Results were based on 2014 to 2024 data from the biennial Physician Practice Benchmark Survey, conducted by the AMA Division of Economic and Health Policy Research.
The compensation portion of the survey looks at what physicians who have completed residency, are delivering at least 20 hours of patient care a week, and who do not work for the federal government say about the way they are paid. Physicians in solo practice are excluded from compensation survey questions.
The surveys collect detailed information about the practice arrangements of physicians, including the methods used to compensate physicians. In them, physicians were asked to indicate if salary, personal productivity, practice financial performance, a bonus unrelated to personal productivity or practice financial performance, and/or some other method factored into their compensation. Then, for each compensation method they received, physicians were asked to indicate the percentage of their income that came from that method.
When compensation structure varies
The report shows some differences by physician specialty, particularly in surgical specialties—where productivity tended to be a larger proportion of compensation than it was with other specialties—and radiology, where practice financial performance was more influential in determining a physician’s compensation than it was with other specialties.
The analysis also shows differences by gender. In 2024, female physicians had a higher average compensation share from salary compared with male physicians, and male physicians had a higher average compensation share from productivity compared with female physicians.
“Even though we don't know the dollar amount, it could suggest that there is potential for more upside for men’s compensation because they have that bigger productivity component, which is more variable, whereas the salary is a bit more stable,” Igwe said.
Additionally, there was variance by the physician’s employment status, with owners getting less salary-based income and more productivity or performance-based income than employed physicians. But for both employed and practice-owning physicians, the proportion of their compensation that came from salary rose from 2014 to 2024.
“An owner has a financial stake in the practice and is inevitably going to be more impacted by the productivity and the practice's financial performance,” Igwe said.
Physicians working in hospitals or multispecialty practices tended to have higher salary shares than those in single-specialty practices.
“Overall, physician compensation models have become increasingly blended, balancing financial stability with incentives for productivity, and reflecting broader changes in employment practices and organizational structures in health care over the past decade,” Igwe wrote in the report. “This AMA Policy Research Perspective delivers unique, nationally representative estimates of multiple compensation methods and provides a clearer understanding of the underlying factors that influence physician income.”
For research on other topics based on the Physician Practice Benchmark Survey, visit the AMA’s resource page here.
Physician job seekers should explore the JAMA Career Center®, which presents physician career opportunities, news and information relevant to the full spectrum of medical practice. Search for physician jobs by specialty and location or browse all of the physician jobs by specialty.
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