ER Doctor Salary 2025: How Much Emergency Physicians Actually Make

Introduction (2025 Salary Benchmarks)

Attending emergency medicine physicians are well-compensated in 2025, typically earning in the mid-to-high six figures annually. However, reported salary figures vary depending on the data source and methodology. For instance, a recent Medscape compensation survey found that emergency physicians earn about $388,000 on average, while crowd-sourced physician data from SalaryDr reports a higher median of roughly $425,000 per year for emergency docs (according to SalaryDr’s Emergency Medicine physician salary database). An American College of Emergency Physicians (ACEP) member survey, which included academic and part-time roles, showed a more conservative median of around $330,000 total compensation (including bonuses). Despite differences, these benchmarks indicate that in 2025 an attending Emergency Room (ER) doctor’s annual pay generally falls somewhere between $300,000 and $450,000, reflecting their critical role on the front lines of healthcare. Notably, this places emergency physicians above the national physician median in income, although still below the most highly paid surgical specialties. In the sections below, we’ll break down ER doctor salaries in detail – from typical ranges and experience-based differences to regional and practice-setting variations – and examine how emergency medicine pay stacks up against other specialties and evolving workforce trends.

Salary Ranges and Averages

Emergency physician salaries span a broad range. Most attending ER doctors earn between $380,000 and $460,000 per year in 2025, according to SalaryDr’s analysis of verified compensation data. In fact, SalaryDr finds the middle 50% of emergency medicine salaries clustered in that ~$380K–$460K band, with top performers (90th percentile) reported to earn up to $1 million+ annually. ACEP’s 2025 survey similarly found a wide distribution: the 25th percentile of emergency physician total compensation was about $248,000, while the 75th percentile was around $432,000. This means the highest-paid ER attendings make nearly double what the lower-paid quarter earn.

It’s important to note that these figures typically include base salary plus any bonuses, productivity incentives, or profit-sharing. Emergency medicine often has productivity-based pay (e.g. per RVU or per patient) and bonus structures, which can significantly boost income for high-volume physicians. For example, SalaryDr data shows an average base salary around $355K with ~$50K in additional incentives for ER doctors, totaling ~$410K annually on average. Many emergency physicians also work roughly 1 full-time equivalent (about 36–40 hours per week of clinical time, often in shifts), so these salaries correspond to roughly $200–$250 per hour of clinical work. For context, the U.S. Bureau of Labor Statistics reports an average wage equivalent to about $310,000 per year for emergency physicians in recent data, but this largely reflects base salary only and excludes extras. In practice, most full-time attending ER physicians in 2025 can expect a solid six-figure income approaching $0.4 million annually, with exact placement in the range depending on factors we’ll explore (like location, experience, and practice type).

Compensation by Experience Level

Unlike some careers, emergency medicine doesn’t have dramatic pay increases with decades of experience – it’s a specialty where new attendings can earn a strong salary early on, and income then grows modestly. SalaryDr’s data shows that early-career emergency physicians (just out of residency) often start with total compensation in the low-to-mid $400,000s. In fact, their analysis found entry-level ER positions averaging about $433K, which is already around the overall median for the specialty. Physicians with 10+ years of experience reported typical salaries around $467K, only about an 8% higher than those of new attendings. This relatively flat growth curve suggests that in emergency medicine, a doctor’s earning power reaches a high level early and then plateaus.

There are a few reasons for this. First, ER salaries are often determined by market rates for staffing emergency departments – a hospital must pay enough to recruit either a new graduate or a veteran, and that rate is set by supply and demand more than tenure. Additionally, many experienced emergency physicians reduce their clinical hours or shifts as they get older (to mitigate burnout or health issues), which can keep their annual pay in check. Surveys have observed that physician incomes tend to increase through mid-career and then level off or even dip slightly for doctors in their 60s. Emergency medicine fits this pattern: a doctor in their 40s or 50s may earn at or near the peak, whereas some in their late career choose to go part-time or take on administrative roles that might pay less than full clinical work.

That said, experience can still bring opportunities for leadership stipends (e.g. as an ER director) or partnership in a group, which might boost compensation. But overall, a young attending emergency physician can “hit the ground running” financially – often starting at $300K+ right out of training – and further growth in salary is relatively modest compared to more seniority-based fields. The flip side is that emergency docs don’t need to wait decades to reach a high income; they attain top earnings early in their career, reflecting the intense and in-demand nature of their work.

Regional Differences in ER Doctor Pay

Figure: Annual mean wages of emergency medicine physicians by area (May 2023). Darker regions indicate higher average EM physician salaries (often $350K+), whereas lighter areas indicate lower averages.

Geography plays a major role in how much ER physicians earn. In general, areas with high cost of living or an oversupply of doctors (e.g. certain coastal urban centers) tend to offer lower salaries, while rural or undersupplied regions pay a premium to attract physicians. For example, an ACEP survey found the Northeastern U.S. had the lowest median pay for emergency physicians – around $210 per hour (roughly $300K annual) – whereas the South, Midwest, and West offered about $225 per hour on median, translating to over $350K annual total compensation in those regions. In fact, emergency doctors in the South and Midwest reported median incomes exceeding $350,000, compared to roughly $300,000 in the Northeast.

State-by-state data also reflect this trend. According to SalaryDr and other sources, states like Florida, Texas, and Arizona – which have high ER demand and fewer residency programs – offer very competitive pay. Florida’s average emergency physician salary is around $389,000, notably higher than many states. Some locations in the South (and parts of the Midwest) routinely advertise over $400K plus large bonuses for attending ER physicians willing to relocate. By contrast, in highly desirable but saturated areas like California or New York, ER salaries typically range a bit lower. SalaryDr’s data for all physicians shows California’s typical range around $320K–$480K and New York around $310K–$470K, and emergency specialists in major cities mirror that: e.g. an average of about $400K in New York City vs. $340K in Houston. These differences often reflect supply and demand – popular metro areas have more doctors competing for jobs, while rural and less-populated regions must pay more to staff their emergency departments.

Interestingly, a recent ACEP compensation report noted that rural emergency physicians had the highest median pay of any setting – about $389,500, outpacing urban and suburban docs. Yet only a small minority of ER physicians practice in rural areas (roughly 15% in that survey, indicating that higher pay alone isn’t enough to draw most doctors to remote locations. Many physicians still prioritize lifestyle factors or family considerations over salary when choosing where to work. Nonetheless, the regional pay gap is significant: an ER doctor in a lower-cost state (or underserved area) can earn tens of thousands more per year than one in a prestigious coastal city, after adjusting for the same hours. In 2025’s market, we continue to see lucrative offers – including sign-on bonuses of $100K–$150K for multi-year contracts – in places that struggle to recruit talent. In short, “location, location, location” is very much a real factor in EM compensation, and many physicians find that moving to a high-need region can substantially increase their take-home pay.

Work Setting and Practice Type Impact on Compensation

Where and how an ER physician practices has a substantial impact on their salary. Broadly, private practice or community emergency physicians earn more on average than those in academic or employed positions. In the ACEP 2025 survey, community hospital ER doctors (non-academic) reported a median of $374,300 in annual compensation, whereas those working in academic teaching hospitals had a median around $260,000 – over $100K less. Community EM physicians were also paid higher hourly rates ($230/hour median) than academics ($210/hour). This reflects a common trade-off: academic positions typically come with lighter clinical loads, research/teaching duties, and other benefits, but at the cost of lower salary.

National physician salary data echo this pattern across specialties. According to SalaryDr benchmarks, private practice physicians typically earn in the range of $320K–$450K, compared to $280K–$400K for hospital-employed doctors and only $240K–$350K for those in academia. Emergency medicine is no exception. Many ER physicians are employed by physician-owned groups or private equity-backed staffing companies, and those in leadership or partner roles at private groups often have the highest incomes. By contrast, an ER doctor directly employed by a hospital or medical school might have a lower base salary but potentially better job security, benefits, or work-life balance.

Within emergency medicine, compensation structures can also vary. Some groups pay pure salary, while many use productivity-based pay (e.g. paying per patient seen or relative value unit generated). This means two doctors in the same ER could have different incomes if one works more shifts or sees patients faster. Those who take on administrative titles (e.g. department director) might get stipends but also often reduce clinical hours, which can paradoxically lower their total pay if not offset.

The variance within the specialty can be quite large. One analysis (albeit a few years old) highlighted that an employed emergency physician at the 10th percentile earned about $213,000, while a top-earning partner in a group at the 90th percentile earned around $510,000 in the same period. That is a spread of nearly $300K among ER doctors, driven largely by practice ownership and productivity. In practical terms, an ER doctor who becomes a partner in a democratic group or takes on extra shifts can significantly out-earn a colleague who is an employee working a standard schedule. On the flip side, some emergency physicians deliberately choose employed or academic positions for steadier hours or other non-monetary benefits, accepting a pay cut as a worthwhile trade.

In 2025, the “typical” attending ER physician works in a community hospital setting (often via a contract management group) and this typically yields a generous income. But physicians in that setting are often exchanging higher pay for a heavier clinical load and little academic time off. Those in university hospitals or employed by health systems will see a lower paycheck on average, reinforcing that work setting – whether you are a community doc, academic faculty, or independent group partner – has a major influence on earnings in emergency medicine.

Burnout, Job Satisfaction, and Lifestyle Factors

While ER doctors earn high salaries, the demanding nature of the job has led to widespread burnout and mixed feelings about compensation. Emergency medicine consistently ranks among the specialties with the highest burnout rates. In a 2023 Medscape survey, Emergency Medicine had one of the top burnout levels (alongside Internal Medicine and Pediatrics) – well over half of ER physicians reported feeling burned out. Long and irregular hours, overnight shifts, high patient acuity, and administrative burdens (like EMRs and throughput metrics) all contribute to this stress. Another recent poll found 85% of physicians feel overworked, and more than two-thirds of doctors were considering cutting back hours, changing jobs, or even retiring early due to these pressures. These statistics are sobering: even though ER doctors make a good living, many feel it comes at the expense of personal well-being.

Perceptions of fairness in pay also reflect these strains. In Medscape’s latest survey, only 52% of emergency physicians felt they are fairly compensated for their work – nearly half believe their pay does not adequately reflect their workload and sacrifice. Interestingly, when asked about physicians’ pay in general, an even larger share (58%) of ER docs felt most physicians are underpaid in today’s healthcare system. This suggests a sentiment that while the raw dollar amount is high, the intensity of the work, risk, and years of training justify even higher pay or better conditions. It’s worth noting, however, that many emergency physicians still love the specialty despite the challenges. SalaryDr’s data shows ER doctors reporting relatively high career satisfaction (averaging 3.6 out of 5) and 87% would choose the specialty again if given the choice. Emergency medicine can be incredibly rewarding – offering varied clinical work and the chance to make real lifesaving differences daily – which for many physicians balances out the drawbacks.

Burnout and lifestyle concerns are affecting the workforce in concrete ways. The specialty has seen a dip in residency fill rates in recent match cycles, partly due to warnings about job saturation and burnout. Many mid-career ER physicians are exploring alternatives like locum tenens (temp work), part-time schedules, or non-clinical roles to regain control of their lifestyle, even if it means a pay cut. In fact, a recent Doximity survey noted 77% of physicians would trade some compensation for better work-life balance or autonomy, a clear sign that money isn’t everything. For emergency physicians, quality of life factors (sleep, family time, safety at work) are increasingly important. Hospitals and groups have started responding by offering scribe support, improved staffing ratios, mental health resources, and other incentives to retain physicians. Additionally, the high burnout rates have alerted employers that unless conditions improve, they may have to further increase salaries or bonuses to entice physicians to stay in full-time emergency practice.

In summary, the lifestyle of an ER doctor – shift-based work with high stress – certainly influences how that hefty salary is perceived. Many docs feel “you can’t put a price on my sanity or sleep”, and thus the money must be weighed against burnout. The field is working through these challenges, but in 2025 it remains a double-edged sword: financially rewarding, yet inherently demanding. For those who can achieve a sustainable balance, emergency medicine can still be a satisfying career both economically and personally.

Emergency Medicine Salaries vs. Other Specialties

Emergency medicine is a well-paying specialty, but not the very top of the medical profession. In the overall ranking of physician incomes, ER doctors sit around the middle of the pack for specialists. Medscape’s 2025 physician compensation report ranked emergency medicine 15th out of 29 specialties in average pay. Attending EM physicians (~$388K average) earn significantly more than primary care doctors, but considerably less than the highest-paid surgeons. For example, orthopedic surgeons top the charts at about $560K+ average annual pay, and other surgical fields like plastic surgery, cardiology, and gastroenterology all average well above $500K. In contrast, family medicine and pediatrics languish near the bottom, around $265K–$280K on average. Emergency medicine’s ~$380K–$400K places it well above those primary care fields and the overall physician average (which is roughly $376K), but still below procedurally oriented specialties.

To put it in perspective, an ER doctor generally earns more than a neurologist or psychiatrist, roughly on par with an ophthalmologist or general surgeon, but less than an anesthesiologist or radiologist. For instance, general surgery averages about $434K and anesthesiology $501K, versus EM at $388K. Meanwhile, an internal medicine doctor (general adult medicine) makes around $294K – substantially less than EM. So, emergency physicians enjoy a higher-than-average income among doctors: one SalaryDr FAQ even notes “Emergency Medicine is considered a high-earning specialty, with median salaries above $400,000 annually”. It’s just that there is a ceiling effect – the ultra-high compensation seen in orthopedic surgery or interventional cardiology isn’t reached in EM, likely because ER physicians don’t generate the same volume of lucrative procedures and typically work fewer total hours than some specialties (due to the intensity of shift work).

Another angle of comparison is income vs. training length. Emergency medicine requires 3-4 years of residency (no fellowship necessary for general EM practice), which is shorter than the training for cardiology, gastroenterology, or surgical subspecialties. Yet EM salaries can be as high or higher than some fields that train longer. This makes EM relatively attractive in terms of earnings potential soon after residency. Of course, as discussed, it also comes with high burnout.

In summary, compared to other specialties, ER doctors make more than most primary care and cognitive fields, and roughly median compared to other specialists. They do not quite reach the pay heights of surgical or sub-specialized physicians. However, emergency medicine’s compensation in 2025 firmly establishes it as one of the better-paying fields, reflective of the acute care expertise and 24/7 coverage these doctors provide. It’s financially rewarding, even if not the number one, and importantly – that income is accessible without the decade-plus of training that some higher-paid specialists must invest.

Future Outlook: Is EM Still Financially Attractive?

Looking ahead, one big question is whether emergency medicine will remain as financially attractive in the coming years. The landscape is somewhat mixed: on one hand, demand for emergency care isn’t disappearing – the population is aging, chronic illnesses are prevalent, and EDs remain a safety net, suggesting continued need for ER physicians. On the other hand, workforce dynamics and reimbursement changes are creating headwinds that could impact salaries.

A critical issue is the oversupply of EM residency graduates relative to available jobs in certain regions. In the mid-2010s, emergency medicine was so popular that new residency programs proliferated. By 2025, this led to a situation where there are more new ER doctors coming out than there are job openings in some desirable areas. An ACEP job market report noted that last year there were ~1,700 emergency physician job openings advertised versus over 2,000 new residency graduates (not to mention experienced docs job-hunting) – effectively, “not enough jobs for the number of residency graduates.”. This oversupply, particularly in urban markets, has begun to slow the growth of salaries. Simply put, if hospitals have many applicants for each ER position, they have less pressure to raise pay.

Recent compensation data reflects this trend. The Medical Group Management Association (MGMA) found that, when adjusting for inflation, emergency physician pay actually decreased ~20% from 2018 to 2023 – the largest five-year decline of any specialty. In nominal dollars, EM compensation only rose ~1.8% over five years, while inflation was ~22%. This suggests that real buying power for ER salaries has eroded, a concerning sign about financial attractiveness. Factors include not only the workforce surplus, but also tightening reimbursement (e.g. Medicare cuts, payor pressures) and the shift of some care out of emergency departments.

However, the outlook isn’t uniformly pessimistic. In many locations, especially those that are less saturated, ER salaries have held strong or even increased. Post-pandemic, some regions saw wages rebound to or above pre-2020 levels, as per ACEP’s report. Hospitals in understaffed areas are offering hefty bonuses and incentives, which indicates continued willingness to invest in emergency care providers. Furthermore, some experts predict that the current surplus of EM doctors may be temporary – if medical student interest wanes (due to the bad press about the job market), residencies will train fewer new docs, potentially correcting the imbalance in the 5-10 year span.

Emergency medicine also continues to evolve with healthcare needs. The rise of freestanding emergency departments, telemedicine, and urgent care could create new roles for ER-trained physicians. And though mid-level providers (NPs/PAs) are increasingly used, the complexity of emergency care means physicians will remain central. The Bureau of Labor Statistics projects positive growth for physicians in general, and emergency medicine’s skillset will remain in demand, especially in rural and inner-city areas that struggle with shortages. So, financially, EM should remain a solidly high-paying career, but the days of unsustainably rapid salary growth are likely over. Future salaries might rise modestly or even plateau in real terms unless significant shortages emerge again.

In weighing the financial attractiveness, one must consider the whole picture: Emergency physicians in 2025 still earn more than the vast majority of American workers (and even most other physicians). The field offers early-career high salaries and nationwide portability of skills. Yet the combination of flattening pay increases, high burnout, and competitive job markets in certain locales means that prospective ER doctors should go in with eyes open. In the coming years, emergency medicine will likely remain a financially rewarding specialty, but perhaps not as “hot” as it once was in terms of rapid income growth. For those who are passionate about acute care, it’s still a lucrative choice – especially if one is flexible on where to practice. And if burnout and workforce issues can be addressed (through better working conditions or systemic changes), emergency medicine will continue to be an attractive career that offers both excellent compensation and the intangible reward of saving lives every shift.

Sources: SalaryDr emergency medicine salary datasalarydr.comsalarydr.com; ACEP Now 2025 compensation reportacepnow.comacepnow.com; Medscape/Becker’s 2025 physician salary surveybeckershospitalreview.combeckershospitalreview.com; U.S. Bureau of Labor Statisticsindeed.com; Weatherby/Medscape EM reportweatherbyhealthcare.comweatherbyhealthcare.com.