These differences may reflect regional variations in cost of living, payer mix, or hospital employment structures. The relatively higher pay in the South and Midwest may also help explain why these regions comprised the largest shares of respondents.

Rural Work: Higher Pay, Still Underserved

One surprising finding showed that physicians practicing in rural settings reported the highest median hourly base pay at $236 and the highest median total compensation at $389,500—outpacing both urban and suburban counterparts. Yet only 15 percent of respondents indicated they practiced in a rural environment.

This contradiction—higher compensation but lower physician density—raises critical questions about what truly drives workforce shortages in rural areas. The issue appears to extend beyond pay, likely involving work-life balance, access to resources, and geographic preference.

Practice Setting Affects Pay

Emergency physicians working in community hospitals reported a median hourly rate of $230, notably higher than those working in academic/teaching affiliates ($210). Community-based physicians also had higher total compensation—$374,300 vs. $260,000—further highlighting the financial trade-offs between academic and community practice models.

A Representative Sample

Although a 3 percent response rate sounds low, it is similar to other surveys of this type, and respondents’ demographic breakdown aligns well with ACEP’s broader membership:

• 71 percent male / 28 percent female, similar to ACEP’s gender distribution of 63/37;
• Age distribution centered around the early-to-mid career stages;
• Geographic and practice setting breakdowns also mirror known ACEP member patterns, suggesting the findings can be confidently generalized to the broader workforce.

Final Takeaway

The 2025 ACEP Salary Survey reinforces known trends—academic and female physicians earn less, rural work pays more but remains underfilled—and provides current benchmarks for emergency physicians to evaluate their own compensation. The findings also raise strategic questions for ACEP’s ongoing advocacy and workforce planning efforts.

For those looking to dig deeper into the data—including detailed tables by employment type, tenure, and compensation structure—ACEP members can access the full report online at acep.org/compensation-report-2025.