This analysis synthesizes 9 sources published the week ending Sep 27, 2026. Editorial analysis by the PhysEmp Editorial Team.
Rheumatology posted the largest raise of any physician specialty this year: 10.4%, to a median $323,882 in total cash compensation, according to SullivanCotter’s 2026 survey of 575 organizations. The same week, Marit Health ranked rheumatology fourth of 36 specialties for lifestyle balance, at a 40.6-hour work week. Neurosurgery, the best-paid specialty at a median $954,500, ranked last. Put the two lists side by side and one of the oldest assumptions in Physician Compensation & Demand starts to wobble: the idea that pay rises in proportion to how hard the schedule is.
Where the 2026 raises landed
The top of SullivanCotter’s raise list reads like a list of specialties with long waitlists and short pipelines. After rheumatology come family medicine with obstetrics and child and adolescent psychiatry (both 9.7%), infectious disease (9.6%) and endocrinology (8.6%). Several of those also sit high on Marit’s lifestyle index, which blends weekly hours, schedule quality, call burden, clinical time and PTO from more than 24,400 physician submissions. Psychiatry ranks fifth, family medicine sixth and endocrinology tenth.
The procedural and hospital-based fields are still getting raises, just not the biggest ones. Anesthesiology rose 7.3% to $567,914 and sits in Marit’s bottom five alongside general surgery, critical care and OB-GYN. General surgeons report 53.7 hours a week. Neurosurgeons report 56.6, eleven hours above the all-specialty average, with 4.6 weeks of PTO.
Radiology is the outlier that gets both. Diagnostic, interventional and breast radiologists saw total cash compensation rise 12% to 18% since 2024, and radiologists also report the most PTO of any of the 36 specialties tracked.
The historical trade was simple: harder hours, bigger check. In 2026 the fastest raises are going to specialties where supply is thin, whatever the schedule, and some of the thinnest are the ones with the best schedules.
A wage gap that built its own shortage
Nobody decided the cognitive specialties were underpaid on principle. The raises trace back to a shortage the old pay gap helped create. Research the AMA highlighted this month found specialty pay strongly tracks Match competitiveness for U.S. MD seniors, and the authors named the primary-care-to-subspecialty wage gap as a likely reason students steer away from lower-paid fields. A generation of students read the pay tables correctly. Health systems are now paying to undo the result, one rheumatologist at a time.
That also explains why the raises cluster in fields with months-long patient waits and few fellowship slots. Employers aren’t pricing effort. They’re pricing scarcity, and in 2026 scarcity has moved toward the quieter clinics.
Hourly math changes the comparison
Headline salaries flatter the demanding specialties. A rough calculation shows how much. Combining the two datasets (Marit’s pay and hours for neurosurgery, SullivanCotter’s median for rheumatology, and an average five weeks off for rheumatology), a neurosurgeon earns nearly three times what a rheumatologist does per year but only about 2.1 times as much per hour worked: roughly $355 an hour against $170. Add call burden, which Marit scores as above average for neurosurgery, and the gap narrows further. These are two different surveys, so treat the ratio as directional. The direction is the point.
Physicians are already doing this math, even when employers aren’t. The Physicians Foundation’s 2026 survey of 1,000 physicians found only 40% of employed physicians feel they control their time away from work, against 55% of independent physicians. Employed doctors were also 2.5 times as likely to name productivity pressure as a top source of distress (34% vs. 13%). Time has become one of the things employment takes away, and physicians notice what they give up.
A $950,000 offer at 57 hours a week and a $325,000 offer at 41 are closer than they look. Candidates who run the hourly numbers will treat them that way.
What most job postings still leave out
Recruiting practice hasn’t caught up. Marit’s recruiting research found that 70% of physicians have a CME allowance, but only 33% of job listings mention one and fewer than 7% state a dollar figure. Hours, call ratios and PTO get a similar silence in most postings. For a specialty in the bottom five for lifestyle, that silence leaves the candidate to assume the worst. For one near the top, the posting leaves out its strongest selling point.
The recruiters with the easiest year ahead will likely be the ones who publish the schedule next to the salary. A hospital hiring an anesthesiologist is already paying $568,000 at the median. Showing a real call schedule and a real PTO number costs nothing and answers the question candidates are asking anyway.
The pressure point for radiology
Radiology currently has the best of both lists, and it is also the specialty most directly in the path of the next reimbursement fight. Federal officials are weighing paying for AI diagnostic tools at 60% to 80% of clinician rates, and in a budget-neutral fee schedule, every dollar paid to software comes out of the pool physicians share. Health systems are paying radiologists 18% more to secure scarce reads today, while Medicare is debating how much a machine-generated read should be worth. Those two prices can’t keep moving in opposite directions for long, and nobody has said which one gives way first.
Sources
15 Physician Specialties With Largest Pay Jumps – Becker’s Hospital Review
The physician specialties with the best lifestyle balance – Becker’s Physician Leadership
The physician specialty that earns $954,500 but ranks last for lifestyle – Becker’s Physician Leadership
Radiologist pay jumps 18% as health systems compete for physicians – Radiology Business
Radiologists report highest PTO among 36 specialties, new data show – Radiology Business
Medical students: Should future earnings shape your specialty? – American Medical Association
Employed vs. independent physicians: More burnout vs. more money, stress: Survey – Becker’s ASC Review
Marit Health Expands Physician Compensation and Lifestyle Analytics to Bolster Recruitment Platform – TipRanks
The Next Big Question in Physician Compensation – Becker’s Physician Leadership