Physician Salary Overview
A Physician in the United States earns a median of $252,000 a year, or about $121.15 an hour over a full-time year of 2,080 hours. A Physician spends their workday diagnosing and treating diseases, ordering and interpreting diagnostic tests, prescribing treatments and medications, performing procedures, managing complex chronic conditions, coordinating specialist referrals, supervising residents, and maintaining evidence-based practice. The band runs from $148,800 to $396,000, a spread of 166 per cent between the two ends, which for this occupation is decided mainly by years in the role and by the employer rather than by job title. On the median salary, federal income tax takes about $52,903 and FICA another $15,040, leaving $184,057 in a state with no income tax such as Texas or Florida; add California income tax of roughly $19,574 and take-home pay falls to about $164,483, an effective rate of 34.7 per cent. Education: The typical path to becoming a Physician involves earning a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) plus 3-7 year residency depending on specialty; board certification required.
The pay band for a Physician is unusually steep: the lead level pays about 2.5 times the entry level, or $383,040 against $151,200. A spread that wide means the occupation rewards accumulated judgement rather than credentials, and it has a practical consequence for anyone starting out: the first offer matters far less than the rate of progression, because the band above is large enough to absorb a modest start within a few years.
The largest single step is the one out of the entry level, worth about $100,800 a year. That places the decisive moment early: the two or three years it takes to stop being junior are worth more than any later promotion, which argues for choosing a first employer on what it will teach rather than on what it pays.
The best-paying states for this occupation are split: NH levies no income tax at all while WI, NE does, so two gross offers that look alike do not end alike. On this median salary the state layer alone is worth several thousand dollars a year, which is why the table below ranks by take-home pay rather than by gross.
Demand concentrates in Milwaukee, WI, Omaha, NE, Indianapolis, IN, and those are also among the most expensive places to live in the country. A premium of ten or twenty per cent on the median does not survive a housing cost twice the national figure, so the right comparison for a Physician weighing a move is take-home pay minus rent, not salary against salary.
The Physician is one of the most important roles in the Healthcare sector of the US economy in 2026. With a median annual salary of $252,000, compensation for this position ranges from $148,800 at the entry level to $396,000 for highly experienced professionals in top-paying markets.
This career typically requires Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) plus 3-7 year residency depending on specialty; board certification required. Valued professional credentials include USMLE or COMLEX for licensure, ABMS board certification in specialty, state medical license, DEA registration, maintenance of certification (MOC). On a day-to-day basis, professionals in this role focus on diagnosing and treating diseases, ordering and interpreting diagnostic tests, prescribing treatments and medications, performing procedures, managing complex chronic conditions, coordinating specialist referrals, supervising residents, and maintaining evidence-based practice.
The job market for this position shows 3% from 2022-2032 with projected physician shortage of 37,800-124,000 by 2034 (AAMC estimates) creating strong demand growth, with demand strongest in specializations including internal medicine, family medicine, cardiology, gastroenterology, dermatology, endocrinology, and hospitalist medicine. AI assists with diagnosis and imaging interpretation, but the physician-patient relationship, complex clinical decision-making, and multi-system care coordination remain fundamentally human
Salary Range: The typical Physician in the US earns between $148,800 and $396,000 per year, with a median of $252,000.
What Does a Physician Do?
A Physician spends their workday diagnosing and treating diseases, ordering and interpreting diagnostic tests, prescribing treatments and medications, performing procedures, managing complex chronic conditions, coordinating specialist referrals, supervising residents, and maintaining evidence-based practice. The role requires proficiency with industry-standard tools and technologies including Electronic health records (Epic, Cerner), diagnostic equipment (stethoscope, otoscope), point-of-care ultrasound, clinical decision support systems, telemedicine platforms.
The typical work environment involves hospitals, medical offices, academic medical centers, or telemedicine; hours vary widely by specialty (dermatology ~45 hrs/week vs. surgery ~60+). Within the profession, you can specialize in areas such as internal medicine, family medicine, cardiology, gastroenterology, dermatology, endocrinology, and hospitalist medicine, each requiring different skill sets and offering different compensation levels.
Day-to-day responsibilities vary based on seniority and organization size. Entry-level professionals often focus on execution tasks under supervision, while senior professionals take on strategic planning, mentoring, and cross-functional leadership.
Physician Salary by Experience
| Level | Salary | Hourly | Take-Home |
|---|---|---|---|
| Entry | $151,200 | $73/hr | $103,899 |
| Mid | $252,000 | $121/hr | $164,483 |
| Senior | $317,520 | $153/hr | $199,844 |
| Lead | $383,040 | $184/hr | $234,515 |
Best and Worst States for Physician Pay
Which states let a Physician keep the most, and least, of their salary, ranked by annual take-home pay.
Geographic location significantly impacts Physician compensation. The top-paying states for this role include South Dakota (cost-adjusted highest), North Dakota (rural premium), Wisconsin (competitive with moderate costs), Kentucky (strong demand), Nebraska (favorable practice environment).
States with no income tax (Texas, Florida, Washington, Nevada, Tennessee) offer an effective pay boost of 3-9% compared to high-tax states like California or New York, though these states often compensate with higher cost of living or property taxes. When evaluating offers, consider both gross salary and after-tax take-home pay.
For a Physician earning $252,000, state choice alone determines a $19,574 swing in annual take-home pay. This is not a theoretical exercise: Healthcare professionals increasingly have geographic flexibility, and understanding that Texas preserves $184,525 of your salary while California only preserves $164,951 should factor into every relocation and remote work decision.
Cost-of-Living Adjusted Analysis: When factoring in regional cost of living, Texas offers the best purchasing power for a Physician salary. While high-tax states like California and New York offer robust Healthcare job markets, their combined tax burden and cost of living can reduce effective purchasing power by 25-40% compared to states like Texas or Georgia. A Physician earning $252,000 in Texas enjoys purchasing power equivalent to approximately $198,414 in a baseline cost area.
Healthcare Market Analysis: Physician demand varies significantly by region. Rural areas offer signing bonuses of $5,000-$20,000 and lower cost of living, while major medical centers in Boston, Houston, and Chicago offer higher base salaries. For Physician professionals, travel assignments can increase effective hourly rates by 50-100%, though tax implications of multi-state licensure and per diem structures require careful planning. States with nursing shortages often offer the best combination of high pay and low competition.
Top 10 Best States for Physician Salary
| # | State | Gross | Federal | State Tax | FICA | Take-Home | Rate |
|---|---|---|---|---|---|---|---|
| 1 | Alaska | $252,000 | $52,903 | $0 | $15,040 | $184,057 | 27.0% |
| 2 | Florida | $252,000 | $52,903 | $0 | $15,040 | $184,057 | 27.0% |
| 3 | Nevada | $252,000 | $52,903 | $0 | $15,040 | $184,057 | 27.0% |
| 4 | New Hampshire | $252,000 | $52,903 | $0 | $15,040 | $184,057 | 27.0% |
| 5 | South Dakota | $252,000 | $52,903 | $0 | $15,040 | $184,057 | 27.0% |
| 6 | Tennessee | $252,000 | $52,903 | $0 | $15,040 | $184,057 | 27.0% |
| 7 | Texas | $252,000 | $52,903 | $0 | $15,040 | $184,057 | 27.0% |
| 8 | Washington | $252,000 | $52,903 | $0 | $15,040 | $184,057 | 27.0% |
| 9 | Wyoming | $252,000 | $52,903 | $0 | $15,040 | $184,057 | 27.0% |
| 10 | North Dakota | $252,000 | $52,903 | $4,629 | $15,040 | $179,428 | 28.8% |
Bottom 10 Worst States for Physician Salary
| # | State | Gross | Federal | State Tax | FICA | Take-Home | Rate |
|---|---|---|---|---|---|---|---|
| 42 | South Carolina | $252,000 | $52,903 | $14,501 | $15,040 | $169,556 | 32.7% |
| 43 | New York | $252,000 | $52,903 | $14,885 | $15,040 | $169,171 | 32.9% |
| 44 | Delaware | $252,000 | $52,903 | $15,401 | $15,040 | $168,656 | 33.1% |
| 45 | Vermont | $252,000 | $52,903 | $16,217 | $15,040 | $167,840 | 33.4% |
| 46 | Maine | $252,000 | $52,903 | $16,480 | $15,040 | $167,577 | 33.5% |
| 47 | Minnesota | $252,000 | $52,903 | $18,167 | $15,040 | $165,890 | 34.2% |
| 48 | District of Columbia | $252,000 | $52,903 | $18,579 | $15,040 | $165,478 | 34.3% |
| 49 | California | $252,000 | $52,903 | $19,574 | $15,040 | $164,483 | 34.7% |
| 50 | Hawaii | $252,000 | $52,903 | $21,857 | $15,040 | $162,200 | 35.6% |
| 51 | Oregon | $252,000 | $52,903 | $22,954 | $15,040 | $161,103 | 36.1% |
Physician Take-Home Pay by City
Rural areas and smaller metros consistently pay $50-150K more than major academic centers; private practice in affluent suburbs offers top compensation
When comparing city compensation, factor in cost of living differences. A $252,000 salary in a mid-cost city often provides more purchasing power than a 20-30% premium in San Francisco or New York.
How to turn these figures into an actual offer, what to ask for besides base pay and when to name a number, is covered in the guide to negotiating a salary offer.
| City | Gross Salary | Total Tax | Take-Home | Rate |
|---|---|---|---|---|
| Milwaukee, WI | $252,000 | $80,211 | $171,789 | 31.8% |
| Omaha, NE | $252,000 | $81,139 | $170,861 | 32.2% |
| Indianapolis, IN | $252,000 | $75,629 | $176,371 | 30.0% |
| Nashville, TN | $252,000 | $67,943 | $184,057 | 27.0% |
| Birmingham, AL | $252,000 | $80,378 | $171,622 | 31.9% |
Calculate Physician Take-Home Pay
Adjust the state and filing status to see your estimated after-tax income.
Estimated Take-Home Pay
Tax Breakdown
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Pay Frequency Breakdown
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How to Become a Physician
Education: The typical path to becoming a Physician involves earning a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) plus 3-7 year residency depending on specialty; board certification required. Some professionals enter the field through alternative pathways, but formal education provides the strongest foundation for long-term career growth.
Certifications: Key professional credentials for this role include USMLE or COMLEX for licensure, ABMS board certification in specialty, state medical license, DEA registration, maintenance of certification (MOC). These certifications demonstrate expertise to employers and often directly correlate with higher compensation.
Skills & Tools: Proficiency with Electronic health records (Epic, Cerner), diagnostic equipment (stethoscope, otoscope), point-of-care ultrasound, clinical decision support systems, telemedicine platforms is expected for competitive candidates. Building a portfolio of work or gaining practical experience through internships, projects, or entry-level positions is essential for breaking into the field.
Timeline: Most professionals reach mid-level competency within 3-5 years of entering the field, with senior positions typically requiring 7-12 years of progressive experience.
Physician Career Outlook
Employment for the Physician role is projected to grow 3% from 2022-2032 with projected physician shortage of 37,800-124,000 by 2034 (AAMC estimates) creating strong demand, reflecting strong demand driven by industry evolution and changing workforce needs. The most in-demand specializations include internal medicine, family medicine, cardiology, gastroenterology, dermatology, endocrinology, and hospitalist medicine.
AI and Automation Impact: AI assists with diagnosis and imaging interpretation, but the physician-patient relationship, complex clinical decision-making, and multi-system care coordination remain fundamentally human
Professionals who combine deep technical expertise with strong communication skills and adaptability will find the best opportunities in this evolving landscape.
The Physician sits in the middle of its adjacent group. Anesthesiologist pays $312,000, $60,000 more, while Nurse Practitioner pays $124,680, $127,320 less, against this role's $252,000. A position in the middle is the most flexible one: it means both directions are open, and that the decision rests on what the work is rather than on what the next title pays, since the difference in either direction is a matter of thousands and not of multiples.
After tax the picture compresses. In California, this role's median leaves about $164,483, and across the whole adjacent group the spread between the highest and lowest take-home figure is $108,660 a year. That compression is the progressive schedule at work: a gross gap of ten thousand dollars between two neighbouring occupations is worth appreciably less once the marginal rate has taken its share, which is why a move made for the salary alone disappoints more often than the gross figures suggest.
Tax Tips for Physician Earnings
The strategies that apply to every salaried professional, the contribution limits, the bracket arithmetic and the question of moving to a state without an income tax, are set out once in the guide to tax strategies for salaried professionals rather than repeated on each occupation page.
Physician Salary FAQ
The median annual salary for a Physician in the United States is $252,000 in 2026. Compensation typically ranges from $148,800 for entry-level positions to $396,000 for experienced professionals in top-paying markets. Actual pay depends on experience, location, certifications, and employer size. On a median salary of $252,000, take-home pay works out to about $164,483 a year before state-specific credits.
On a $252,000 salary, a Physician takes home approximately $85,000-$105,000 after federal, state, and FICA taxes, depending on the state and filing status. In no-income-tax states like Texas or Florida, take-home pay is higher than in states like California or New York. On a median salary of $252,000, take-home pay works out to about $164,483 a year before state-specific credits.
Entry-level Physician professionals with 0-2 years of experience can expect to earn around $151,200 per year. Starting salaries vary significantly by location, with major metro areas offering 15-30% premiums over rural areas. On a median salary of $252,000, take-home pay works out to about $164,483 a year before state-specific credits.
The highest-paying states for Physician professionals include WI, NE, NH. However, when adjusted for cost of living, some mid-tier states offer better purchasing power. No-income-tax states provide an additional 3-9% effective pay boost. On a median salary of $252,000, take-home pay works out to about $164,483 a year before state-specific credits.
The median hourly equivalent for a Physician is approximately $121.15, based on 2,080 working hours per year. Actual hourly rates vary by experience level, with senior professionals earning $10-30 more per hour than entry-level. On a median salary of $252,000, take-home pay works out to about $164,483 a year before state-specific credits.
To become a Physician, you typically need Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) plus 3-7 year residency depending on specialty; board certification required. Valuable certifications include USMLE or COMLEX for licensure, ABMS board certification in specialty, state medical license, DEA registration, maintenance of certification (MOC). Most employers also value practical experience gained through internships or entry-level positions.
Employment for Physician professionals is projected to grow 3% from 2022-2032 with projected physician shortage of 37,800-124,000 by 2034 (AAMC estimates) creating strong demand. AI assists with diagnosis and imaging interpretation, but the physician-patient relationship, complex clinical decision-making, and multi-system care coordination remain fundamentally human. The strongest opportunities are in internal medicine, family medicine, cardiology, gastroenterology, dermatology, endocrinology, and hospitalist medicine.
A Physician typically spends their day diagnosing and treating diseases, ordering and interpreting diagnostic tests, prescribing treatments and medications, performing procedures, managing complex chronic conditions, coordinating specialist referrals, supervising residents, and maintaining evidence-based practice. The work environment involves hospitals, medical offices, academic medical centers, or telemedicine; hours vary widely by specialty (dermatology ~45 hrs/week vs. surgery ~60+).
Personal finance and taxation expert. Specialized in US federal and state tax calculations, paycheck analysis, and helping Americans understand their take-home pay across all 50 states.
Sources & References
Tax rates, salary data, and deduction figures used on this page are sourced from official US government publications:
- IRS.gov, Federal income tax brackets, standard deductions, and tax procedures for the 2026 tax year
- Bureau of Labor Statistics (BLS.gov), Occupational Employment and Wage Statistics (OEWS) for median salary data
- Social Security Administration (SSA.gov), Social Security wage base, FICA tax rates, and Medicare thresholds
- IRS Tax Withholding Estimator, Federal paycheck withholding calculations and verification
Last reviewed and updated: 2026-09-27. This content is for informational purposes only and does not constitute tax advice.