Question: What are the 20 highest paying jobs in America?
Answer: Doctor.
That’s not far from the truth: According to the Bureau of Labor Statistics, 19 of the 20 American occupations with the highest average wages are doctors or dentists of some kind.
According to federal data, pediatric surgeons are expected to earn an average of $450,810 per year by 2024. Cardiologists earn $432,490. Orthopedic surgeons make $365,060.
Of the 20 highest-paid professions, only one is not a doctor (or dentist), and it ranks last on the list. The 20th highest paid occupation in the US is airline pilot. Pilots, co-pilots, and flight engineers earn an average salary of $226,600.
According to federal data, doctors earn more than any other broad category of workers: even more than engineers. Even more than computer scientists. Even more than lawyers.
Economists say that to find a better-paid group than doctors, you have to reach specific subcategories, such as corporate CEOs and law partners. The average partner of a large firm earns more than $1.4 million per year. The typical S&P 500 CEO could make $17 million in 2024, according to research from Equilar and the Associated Press.
American doctors are apparently paid so well that a group of economic researchers spent years figuring out why.
Here’s what they found.
too many schools, too many hours
As any medical-school applicant knows, to become a doctor you have to study for a very long time: college, then med school, and years of postgraduate residency training.
And the hours are long. The researchers found that a typical doctor’s work week ranges from 40-plus hours to 60 or more hours, depending on the specialty.
“The job requires a lot of training and long hours, and that’s inherently associated with higher earnings,” said Joshua Gottlieb, an economist at the University of Chicago who was involved in the research.
Researchers found that, within the medical profession, doctors earn more in specialties that require more training and longer hours. For example, each additional year of training results in $143,000 in additional annual income.
But education and work hours don’t tell the whole story. An old federal report shows that farmers and ranchers work long hours, and they don’t earn doctor salaries.
As far as training goes: Many of Gottlieb’s colleagues in academia spend the same number of years in school as doctors. And most professors make less than $100,000 a year.
“My brother is an emergency room physician, and I was in school longer than him,” Teresa Ghilarducci, an economist at the New School for Social Research in New York, said, speaking to USA TODAY in 2024. She was not involved in the research cited above.
doctors love money
The researchers criticized doctors for saying this, but they found that physicians tend to seek higher-paying jobs.
In a 2024 paper, researchers reported that doctors from the best medical schools tend to land in the highest-paying specialties. Doctors also favor procedures that provide greater benefits.
Some medical specialties pay surprisingly well. Here are some of the top salaries for doctors ages 40 to 55 in their highest earning years, according to researchers. Figures are from 2017, so they may be higher now:
- Neurosurgery: $920,500
- Orthopedic Surgery: $788,600
- Dermatology: $655,200
- Heart surgery: $607,300
- Ophthalmology: $597,000
“We see people gravitating toward specialties where salaries increase,” Gottlieb said. Like salary conscious workers in any sector. “I think that’s the humane way.”
Maria Polyakova, associate professor at Stanford Medical School, joined Gottlieb in the research. She notes that med school graduates are exceptional students with lots of career options.
“For the most part, they are the top students in the country who could have taken advantage of other opportunities that pay equally well,” he said.
Doctors often spend 12 to 15 years in training, typically leaving medical school with about $200,000 in debt, the American Medical Association said in a statement to USA TODAY. The increased salary helps them get out of debt and make up for years of missed work.
there are not enough doctors
According to the Organization for Economic Co-operation and Development, the United States has fewer doctors per capita than other developed countries: 2.7 per 1,000 potential patients by 2022, compared with 3.8 in France and 4.6 in Germany.
Researchers say a big reason 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.
This shortage dates back to an era when health-industry leaders believed there were too many doctors in America. The irony is that the same groups are now warning of a shortage of doctors.
The AMA says its changing stance reflects the evolving state of the industry, noting that the current generation of doctors is aging and struggling with burnout.
“We have an artificially limited supply of doctors,” said Andrew Biggs, a senior fellow at the liberal American Enterprise Institute, who did not join Polyakova and Gottlieb in the research on doctors.
“Economists call it a barrier to entry,” he said, “and it drives up doctors’ salaries.”
The AMA is “acting like a union for doctors by limiting the number of doctors,” Biggs said. “The purpose of this is to keep wages high.”
government sets prices
Researchers say a fundamental reason doctors earn so much is that the cost of medical care is so high. And the federal government largely sets those prices.
Medicare, the federal insurance program, sets prices for medical services. Prices are so high that spending on health care is 18% of the country’s GDP.
“The government has made a decision, a policy has made a decision, to devote a very large portion of society’s resources to health care,” Gottlieb said.
Customers – patients – have little say over the cost of their medical care.
“It’s not like you’re going to compare prices across surgeons,” Biggs said.
Economists say this arrangement makes the health care sector almost unique among American industries.
“In some ways, the medical industry is like a defense contractor,” Ghilarducci said. “Their main customer, the federal government, has deep pockets.”
