Physician Compensation Strategy in Turbulent Times

Physicians are navigating one of the most turbulent and disruptive periods in modern healthcare. With rising patient demand, longer wait times, staffing shortages, administrative burdens, and additional cuts to wRVUs expected on January 1st, physicians are rightfully concerned about their financial stability — even though they are working harder than ever.

For many physicians, focusing on the guaranteed base salary portion of their compensation may be the best strategy for financial well-being and peace of mind, especially as their productivity and wRVUs are increasingly influenced by factors outside of their control.

Here are the five trends shaping physician compensation today — and what they mean for your financial well-being.

1. Physician Shortages and an Aging Workforce Are Increasing Pressure

AAMC projects a shortage of 13,500 to 86,000 physicians by 2036. Nearly 50% of physicians are over age 55, and 23% are 65 or older. It’s an issue of supply and demand—too many patients in need of care, and too few physicians to provide it. While this can be leveraged for negotiating a new or existing employment agreement, the strain on physicians is taking a toll.

The 2024 Doximity / Curative Physician Compensation Report documented the resulting strain on physicians:

88% of Physicians say shortages affect their practice
74% report moderate to severe impact
67% report burnout tied to staffing gaps
50% have considered leaving clinical practice

Furthermore, the report highlights a significant impact on physician morale:

81% feel overworked
60% report declining satisfaction
87% see longer wait times
75% worsening disparities
70% report delays in patient care

2. Workload Is Rising, but wRVUs Aren’t Keeping Up

Physicians are seeing more patients, navigating more complex cases, and spending more time on documentation and prior authorizations — yet many report flat or declining wRVUs due to system inefficiencies.

The 2025 MGMA Data documents a trend in which patient encounters are rising while wRVUs are falling or remaining flat for many specialties.

This trend indicates:

A shift toward shorter, lower wRVU procedures being performed,
Perhaps undercoding, coding mistakes, or documentation issues,
Prior authorization delays and denials,
APPs earning more credit for encounters and procedures previously captured by physicians.

This mismatch reflects system strain, not physician effort, but the result puts productivity-based compensation at risk.

3. Compensation Is Rising, but Not Commensurate with Inflation

While the 2025 MGMA DataDive Report shows annual compensation increases of 3.17% to 5.57%, roughly matching inflation, the 5-Year gains in median physician total compensation have not kept pace with the 21.2% 5-Year change in CPI.

4. Leadership, Supervision, and Administrative Responsibilities Should Be Compensated

As staffing shortages persist, many physicians are absorbing additional supervisory, teaching, and administrative and leadership responsibilities. The 2025 MGMA data shows that physicians who are compensated for these duties earn 6–13% more.

If your role has evolved, your compensation should reflect it. Especially if these non-clinical responsibilities impact your clinical productivity – which they likely do.

5. The Gender Pay Gap Persists Despite Improvements

Despite modest year-over-year improvements, the gender pay gap remains one of the most persistent inequities in physician compensation — and the Doximity Report reinforces how substantial the gap continues to be.

According to the 2024 report:

The gender pay gap narrowed slightly to 23%
Women physicians earn an average of $102,000 less annually
Women report higher burnout tied to lower pay and heavier nonclinical workload
Nearly 50% of physicians are unsure whether a pay gap exists in their own organization

Why the gap persists:

Lack of compensation transparency
Unequal access to paid leadership opportunities
Disproportionate unpaid labor (“glue work”) falling on women
Lower starting salaries that widen over time

The gender pay gap is not a reflection of performance — it is the result of longstanding structural inequities. Closing the gap requires greater clarity around compensation by sharing physician compensation data, transparent benchmarking, and intentional, routine physician audits across organizations.

What is the Bottom Line for Most Physicians? Your Guaranteed Base Salary is the Key to Financial Security.

A competitive and guaranteed base salary helps buffer against:

Staffing challenges
OR/clinic disruptions
Billing and coding errors
Prior authorization and documentation delays
Ongoing wRVU volatility

In unpredictable environments, predictable compensation supports physician well-being and retention.

My Advice? Adopt a Strategy for Success!

Know your KPI’s (Key Performance Indicators), track your compensation and productivity trends, and review and negotiate routinely.

Review and potentially renegotiate your guaranteed base salary
Reevaluate, and adjust, if necessary, your wRVU thresholds
Get compensation for leadership duties and excess on-call coverage
Review your numbers. Request 3 years of wRVUs, total encounters, gross charges, and total collection data.
Consider rebalancing your compensation plan to bolster your guaranteed base salary and limit at-risk productivity incentives.

Final Thought: Your Value Deserves Stability

Your commitment to patient care and outcomes is extraordinary. You deserve a compensation structure that is fair and transparent, reflects your value — and provides financial stability that brings peace of mind.

Work With SCC to Strengthen Your Compensation Strategy

Customized Compensation Consulting for Physicians

At SCC, we are Physician Advocates! We specialize in this important work, helping physicians navigate compensation opportunities and verify fair pay. We would be delighted to work with you to provide data-driven guidance as you navigate your professional journey.

Contact us for one-on-one coaching support around physician compensation and negotiation. We can review your current compensation, provide an analysis using MGMA Physician Compensation Data and benchmarks, offer strategy and recommendations, and create a customized consultation plan tailored to your goals.