Medscape Dermatologist Compensation Report 2026

1_Derm_Compensation_2026.pngPay gains eluded dermatologists in the US in two consecutive Medscape surveys. Yet, compared to the previous year, dermatologists more often said they felt fairly paid, and around half of them expected to finish 2025 with some level of compensation increase. (Note: Respondents were full-time physicians who practice in the US only, and they reported total compensation including base salary, incentive bonus, and other income such as profit-sharing contributions.)In this report, gender is based on how physicians self-identified in our survey.Some totals in this presentation do not equal 100% because of rounding.2_Derm_Compensation_2026.pngDermatologists practicing in the US told Medscape their compensation fell by roughly 1% on average in 2025. Doctors generally said their pay increased by about 3% on average last year, with average growth rates for both primary care physicians (PCPs) and medical specialists also in that neighborhood.Many physicians worry about inflation lately, and that average pay gain among physicians overall outpaced the annualized core inflation rate for the US of 2.7% at the end of 2025.Matthew Wells, PhD, a senior director at Alexandria, Virginia-based AMGA Consulting, saw 2025 as "a return to normalization" with doctor compensation and looks for "consistency with increases" moving forward.The key drivers, Wells says, are rising individual physician productivity based on seeing more patients and generating more work relative value units (wRVUs), combined with improved technology-driven efficiency in their business offices.3_Derm_Compensation_2026.pngPractitioners in eight specialties topped $500,000 in total annual compensation. All of them except otolaryngology also reported $500,000-plus in income for last year's report. Pediatrics and public health & preventive medicine also trailed the pack in pay in our prior survey."I absolutely am not surprised that orthopedics, cardiology, and radiology are at the top of this list, based on the supply of practitioners nationally and demand for procedures," says Angie Caldwell, a Tampa, Florida-based principal with PYA Accountants & Advisors, which also performs healthcare consulting."I think more medical students will go into these specialties and others not only because of the compensation but based on the impact of research and technology on that specialty as well. This benefits some geographic markets more than others. Look at Florida, for example, where so many advances have occurred in orthopedics with hip and knee replacements that have moved from a hospital setting to outpatient."4_Derm_Compensation_2026.pngWhile healthcare professionals frequently are urged to be forthright in bargaining for pay and benefits, 67% of dermatologists — and 63% of physicians generally — in Medscape's survey said they didn't get more than "moderately" aggressive the last time they negotiated salary in their contract. And many of the others simply didn't have an opportunity to bargain."The hospitals I work for once negotiated physician compensation individually, but that has changed as they became part of bigger organizations," says Chad Stutelberg, national managing director of healthcare compensation and rewards for Arthur J. Gallagher & Co., a Rolling Meadows, Illinois-based risk management consulting firm."Now, I routinely tell employers: Do not negotiate. Come up with a standard compensation philosophy and agreement, and when the doctor comes back to you and says, 'I'd like to negotiate,' say no, we don't negotiate. This idea that whoever is the best negotiator gets the best deal is a bad philosophy for an employer that is trying to build a collaborative environment. Trust me, other physicians would know 5 minutes later what the other doctor negotiated."But a Florida surgeon in our survey thinks the balance of power could shift. "I think that there are not enough physician specialists being produced and as the population ages, they may be able to negotiate better contracts," he said.5_Derm_Compensation_2026.pngWhen Medscape asked dermatologists for last year's report whether they felt fairly compensated for their work, 55% answered "yes," compared with 48% of doctors generally who replied that way. For the profession overall, that was the most dispirited response we had received in 10 years of posing that question in surveys.So, these latest data from dermatologists could point to a rebound from burnout, pressures to see more patients and complete more documentation, and other career hassles.The perception of "fairness in compensation can be influenced by so many different factors that are unique to that provider or medical group," notes Danielle DuBord, a senior consultant at AMGA. "If there are staffing issues at your employer, it can affect whether you feel fairly compensated, even though that doesn't directly involve the comp structure."6_Derm_Compensation_2026.pngThe previous slide showed that 65% of dermatologists in our survey felt fairly compensated individually. But a similar share (68%) believed that the medical profession generally in the US is underpaid, the same as in last year's survey.It's understandable that doctors would want to cheerlead for higher pay for a profession that has been struggling for years with a pervasive burnout problem, Caldwell says."Compared to the rest of the world, we are overpaid. But the cost of living and also burnout are much higher here in the US," an emergency medicine physician from Kentucky told us.7_Derm_Compensation_2026.png8_Derm_Compensation_2026.pngForty-nine percent of dermatologists (46% in our prior report), and just over 40% of physicians generally, expected to end the year with some level of compensation increase. Meanwhile, 40% of dermatologists expected flat pay and 11% said their year-end pay would dip vs the prior year's compensation; these shares were 32% and 20%, respectively, in last year's report.Stutelberg suspects that many of the physicians anticipating a pay cut are in private practice and "facing the headwinds" of Medicare reimbursement rates. "With costs going up and reimbursements staying flat, of course private practice physicians are not real positive on the outlook for their wages," he says.9_Derm_Compensation_2026.pngEven if a dermatologist feels the compensation can't make up for the long, stressful hours and limited family time, does it at least cover the essentials — routine family living expenses, mortgages and other debts, retirement investments — at a respectable rate?In last year's report, 29% of dermatologists said their paycheck exceeded their family's financial needs, 45% said it matched needs, and 26% said it fell short. Among doctors generally for this year's report, the comparable percentages were 28%, 44%, and 28%, respectively.This is another area, Wells and DuBord believe, where doctors' opinions inevitably are influenced by their working conditions and not just by their family's financial picture, inflation, and cost of living in their areas.10_Derm_Compensation_2026.pngCardiology, radiology, and anesthesiology ranked among the top 5 specialties for compensation growth while also ranking in the top 5 for average total pay (see slide 3).Apart from that rich-get-richer theme, nine specialties reported flat pay or declines in our latest survey vs seven in last year's report. (Dermatologists reported a decline for both years.) Year-over-year dips in compensation can reflect doctors taking on flexible or reduced schedules for better balance, but they can also point to austerity measures by practices."At the top of this group, there's so much demand for radiologists and so much remote radiology work now, as well as ophthalmologists' benefiting financially from ownership in their own ambulatory surgery centers," Caldwell comments."I'm a little surprised by the number of declines. This could also reflect having a high Medicare patient volume at a time when the Medicare conversion factor declined, plus pressure generally on reimbursement rates."11_Derm_Compensation_2026.pngThe gender compensation gap was just over an average $102,000 in male doctors' favor in our latest survey, or a 31% advantage (compared with roughly $91,000 and 29% 2 years earlier). The gender gap was more pronounced for specialists than for PCPs over that time period.In short, if you were looking for progress with pay differentials for female physicians — be they structural or based on individual doctors' career choices — you won't find it in these data.The overall issue "is not getting better," and Stutelberg still sees medical employers with gender equity problems in physician base pay and bias for men in awarding signing bonuses."Ideally, as medical organizations pay more attention to the problem, things will start getting better, and the differences in pay will become more attributable to differences in productivity."12_Derm_Compensation_2026.pngOver a 2-year period, White physicians surveyed by Medscape reported 6.1% higher total compensation on average, vs 6.0% for Asian American doctors, 3.5% for Hispanic/Latinx physicians, and 2.9% for Black doctors.Average incentive bonuses in 2025 were roughly $51,000 for White doctors and $47,000, $43,000, and $32,000 for their Asian American, Hispanic/Latinx, and Black peers, respectively.13R_Derm_Compensation_2026.pngAmong the 74% of dermatologists who could qualify for an incentive bonus, the two leading factors that could increase or diminish their award were RVUs generated and number of procedures.An even greater share of physicians generally in the US — "probably about 85%" — have an opportunity for some kind of productivity-based pay, be it a bonus or some other plan, according to Stutelberg."RVUs are going to be by far the most common way of calculating these bonuses. I found the number of doctors who chose patient mix and payer mix interesting and I would think many are in private practice rather than employed."14_Derm_Compensation_2026.pngThe previous slide showed the share of dermatologists we surveyed who had an incentive bonus program available at work. Medscape also asked dermatologists to rate their ability to maximize the award, given its rules.They more often gave a favorable answer (5 or 4 on our 5-point scale) than indicated it was tough to bump up the bonus (1 or 2), which seems a positive indication that bonus plans worked as intended. Forty-seven percent of physicians overall answered 5 or 4 in our survey, and 23% chose 1 or 2.In a profession where physicians are increasingly frustrated with their declining control, even a small bonus program that they can influence by following clear rules can carry outsized importance, Stutelberg feels."Employers need to be really careful with these incentive programs, because you can do a lot of damage with a bad one," he warns. "RVUs — physicians may not like being evaluated based on volume, but they can control it, right? Whereas they may feel a quality care matrix is totally out of their control."15_Derm_Compensation_2026.pngIn Medscape's prior-year survey, 23% of dermatologists told us yes, they found time and opportunity to take on paid work outside of their regular working hours. In our latest survey, 40% of physicians generally reported they did (39% of PCPs, 40% of specialists)."So many physicians are being asked to extend their work days to increase patient access," Caldwell notes."Also, specialists in orthopedics and cardiology see frequent opportunities to become key opinion leaders" in a paid role. "It can feed into their personal mission focus" despite the stress of working more hours.16_Derm_Compensation_2026.pngDermatologists told Medscape they work 44 hours per week on average, compared with 42 hours in last year's report and 49 hours for doctors generally. Might some be underestimating? It's possible. AMGA's research indicates physicians broadly average 36-40 hours per week of patient-facing time, while charting may require at least 4-6 hours a week in primary care — not to mention administrative work and periodic call duties in certain specialties.As for contract length, dermatologists' responses are similar to those of physicians overall, 30% of whom are contracted to work for 1 year or less, 43% for 13 months to 3 years, and 28% for more than 3 years.Wells thinks our data for physicians overall show three general scenarios. Physicians working under a contract that lasts less than a year often are brought in for a short-term project, he says, or pursue locum tenens or per diem jobs for improved work-life balance.Meanwhile, 2-3 years is a frequent standard length for physician contracts. And Wells says the longest-lasting contracts actually are "evergreen deals" that are renewed annually until either the doctor or medical practice decides to terminate them.17_Derm_Compensation_2026.pngForty-five percent of dermatologists in our survey (44% in last year's report), and 35% of physicians generally told us that quantifiable metrics such as RVUs now influence their base pay and not just an incentive bonus."I have designed compensation plans where you want a similar base across all physicians in the interest of parity and fairness, but that also allow an opportunity for the individual doctor to drive…a higher level of guaranteed compensation," Caldwell says. "Your factor for parity and fairness becomes the compensation per wRVU."Whether this approach becomes more common in the future is definitely a foundational question for a medical organization when they design physician compensation."18_Derm_Compensation_2026.png19_Derm_Compensation_2026.pngRelated Content on Medscape'A Return to Normalization': Medscape Physician Compensation Report 2026View All Physician Compensation Reports by Specialty Medscape Physician Wealth & Debt Report 2026: Is the Rising Net Worth Tide Carrying Your Boat?The Race for Relevance: Medscape Most Popular Specialties for Doctors Report 2026