The Impact of Clinical Specialty on Physician Leader Pay

In August 2025, BFMV issued the latest edition of its Physician Leaders Compensation Report. The report is based on Form 990 data filed by nonprofit hospitals and health systems across the country. It includes statistics on compensation paid to physicians in leadership positions in hospitals, medical groups, and other types of organizations. 

In the clinical realm, a physician’s specialty is a primary determinant of compensation. BFMV researched the clinical specialties of each physician leader included in the Physician Leaders Compensation Report to determine if physician leader pay is also influenced by clinical specialty.

One of the first things that stands out about the data is that primary care physicians are very present in physician leadership. Out of a total of 3,474 physician leaders and 40 specialties, the 10 most common clinical specialties were:

1. Family Medicine (951 leaders)

2. Internal Medicine (640 leaders)

3. Psychiatry & Neurology (470 leaders)

4. Pediatrics (251 leaders)

5. Emergency Medicine  (189 leaders)

6. Obstetrics & Gynecology (165 leaders)

7. General Surgery (91 leaders)

8. Anesthesiology (59 leaders)

9. Hospital Medicine (58 leaders)

10. Cardiology (46 leaders)

Some of the leadership positions in the report showed more inclusivity when it came to clinical specialty. Out of a total of 19 leadership positions and 40 specialties recorded, the most diverse, in terms of clinical specialties, were:

1. Chief Medical Officer (38 specialties)

2. Medical Director (38 specialties)

3. Physician Leader/Department Head (31 specialties)

4. Chief of Staff (30 specialties)

5. VP Clinical/Medical Affairs (26 specialties)

Another significant finding was that physician leaders in surgical specialties were the highest paid. Out of a total of 3,474 physician leaders and 40 specialties, the 10 specialties with the highest-paid physician leaders were:

1. Pediatric Surgery ($935,092)

2. Surgical Oncology ($846,216)

3. Transplant Surgery ($793,502)

4. Gastroenterology ($770,871)

5. Thoracic Surgery ($764,583)

6. Vascular Surgery ($714,469)

7. Cardiology      ($662,523)

8. Neonatal Medicine ($612,411)

9. Orthopaedic Surgery  ($600,118)

10. Hematology & Oncology ($587,936)

Based on our research, some of the leadership positions where clinical specialty appears to impact pay the most are:

1)     Medical Director

The 20 Medical Directors who specialized in General & Preventative Medicine had a median compensation of $175,952, while the 5 Medical Directors who specialized in Thoracic Surgery had a median compensation of $1,122,843, a difference of $947,251.

2)     Chief Medical Officer

The 6 Chief Medical Officers who specialized in General & Preventative Medicine had a median compensation of $227,933. However, the 9 CMO Gastroenterology specialists had a median compensation of $705,895, a $477,962 increase.

3)     Physician Leader/Department Head

The 25 Physician Leaders/Department Heads who specialized in Family Medicine had a median compensation of $245,426, while the 6 who specialized in Thoracic Surgery had an average compensation of $865,911, a difference of $620,485.

4)     Chief of Staff

The 10 Chiefs of Staff who specialized in Anesthesiology had a median compensation of $226,364, while the 11 Chiefs of Staff who specialized in Orthopedic Surgery had a median compensation of $876,332, a difference of $649,968. 

Overall, the report's findings indicate that clinical specialty does appear to impact physician leader pay in certain physician leader positions. For more details, purchase the report in our shop.