As emergency medicine continues to evolve amid changing reimbursement, workforce pressures, and shifting practice models, understanding physician compensation remains critical. With the retirement of long-time ACEP Now columnist Barbara Katz, who has traditionally performed an annual compensation report, ACEP solicited its own 2025 Salary Survey, conducted in partnership with Readex Research. The 2025 Salary Survey offers a timely and comprehensive snapshot of how emergency physicians are compensated across the country—and how those figures vary by role, region, gender, and practice setting.

With more than 1,600 qualified responses from actively practicing emergency physicians, the survey provides both topline insights and deep dives into critical demographic and professional variables. The results reveal compensation gaps, regional disparities, and persistent differences across gender and practice type, while also affirming that in many ways, the survey sample closely reflects ACEP’s broader membership.

Topline Compensation Trends

The median hourly clinical base pay for all respondents was $222, translating to a median annual total compensation of $330,000 when including bonuses, profit-sharing, and partner distributions. Physicians at the 75th percentile reported total compensation nearing $432,000, whereas those at the 25th percentile earned closer to $248,400.

Among roles, emergency physicians reported the highest median hourly base pay at $225 and a total compensation of $360,000. Faculty and academic physicians trailed with a median base pay of $210 and total compensation of $249,100, reflecting both the ongoing pay disparity and the uncompensated non-clinical responsibilities often associated with academic roles.

Administrators reported a similar median hourly rate of $223, but significantly lower total compensation of $180,700, likely because of lower clinical hours that are often offset by administrative stipends not fully captured in the survey.

Gender and Age Gaps

One of the most significant findings remains the gender compensation gap. Men earned $13 more per clinical hour than women on average ($225 vs. $212), and their total compensation was $62,000 higher annually at the median level. Although this gap is consistent with national trends, it remains a stark reminder of ongoing inequities within health care.

Age also plays a role in compensation trends. The survey found a gradual increase in income through mid-career, with a leveling off or slight decrease among physicians aged 60 and older. The median age of respondents was 43, which closely matches ACEP’s overall member demographics, and validates that the results are broadly representative.

Geography Still Matters

Where you practice continues to have a noticeable effect on pay. The Northeast reported the lowest median hourly rate at $210, whereas physicians in the South, Midwest, and West all reported $225 per hour. Total compensation in the South and Midwest exceeded $350,000 compared with $300,300 in the Northeast.

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.