Pay

What do dermatologists earn?

Salaried dermatologists earned a mean of $347,810 a year in May 2024, according to the Bureau of Labor Statistics, across 10,080 employed nationally.

Mean annual wage, May 2024: $347,810
Employed nationally, May 2024: 10,080

These are salaried figures. BLS surveys employers, doesn't cover the self-employed or owners and partners in unincorporated practices, and leaves out pay such as year-end bonuses. So they can understate what partners and practice owners earn, and they don't show how pay is split between a base salary and production.

Practice

How is dermatology changing?

Fewer physicians own their practices than a decade ago. In the AMA's 2024 survey, 42.2% of all physicians were in private practice, meaning a practice wholly owned by physicians, down from 60.1% in 2012, and 6.5% were in practices owned by private equity firms. The AMA doesn't report dermatology on its own.

Private equity investment in dermatology has grown. A study cited by the GAO found that private equity firms had invested in practices employing 11% of dermatologists in 2021, up from roughly 2% in 2012. The same study found that in 4% of metropolitan areas, private equity firms had invested in practices employing more than half of dermatologists. That is a share within some local markets, not a national figure.

So a first offer may come from a physician-owned practice, a hospital or academic department, or a practice with private equity investment. None is better in itself. Each changes how you're paid, what you might own and what you'd sign.

The first year

Your first year as an attending

The first twelve months bring the same decisions for most new attendings, in roughly this order. The full checklist goes through each one.

The first-year attending checklist

Disability insurance

Your income is what most of the rest of the plan depends on. Read how your employer's group coverage defines disability and how much of your pay it replaces, then decide whether an individual own-occupation policy belongs alongside it.

Student loans

Pick a repayment path on purpose rather than by default. Forgiveness, repayment plans and refinancing each depend on your loans and your employer, and moving federal loans to a private lender gives up options you can't get back, so compare before you move anything.

Retirement accounts

Learn what your employer offers, what the match is and how long it takes to vest, and when you can join. Above the Roth IRA income limits, a backdoor Roth may be worth reviewing with your tax professional.

Your contract and signing bonus

Read what you would repay if you left early, and how a signing or relocation payment is taxed and withheld. Your attorney reads the agreement; we help you see what it means for your household.

An emergency fund

Hold enough cash to cover your fixed costs for a stretch without income, before raising spending or investing more. The right amount depends on your household and how settled your job is.

Life and umbrella insurance

If anyone depends on your income, term life insurance is worth a look. Umbrella liability coverage sits above home and auto policies. We advise and coordinate with your insurance professional; we don't sell insurance.

What's different in dermatology?

These are questions to ask before you sign and during the first year. The contract is for your attorney and the tax for your accountant. We advise and coordinate with both; we don't negotiate contracts or value practices.

01

How is your pay built?

Ask whether it's a base salary, a share of what you collect or produce, or a base with a production bonus. Ask how production is measured, what the threshold is, how long any fixed starting salary lasts, and what happens to your pay when it ends.

02

Is Mohs or cosmetic work paid differently?

If you'll do Mohs surgery or cosmetic work, ask how each is credited, whether it's paid on the same formula as medical dermatology, and who keeps what share. Ask how sales of cosmetic products are counted, if at all.

03

Who owns the practice, and has that changed?

Ask who owns it today, whether it has been sold in the last few years, and whether another sale is expected. Ask whether physicians can still become owners and, if equity is offered, what you'd own, when it vests and when you could sell it.

04

Is there a partnership track?

If the practice is physician-owned, ask how long until partnership, what the buy-in costs and how the practice was valued, and what you get back if you leave. We look at what a buy-in does to your cash flow and loans next to your other goals.

05

What does the agreement restrict?

Ask where and for how long you couldn't practice if you leave, whether you can tell patients where you've gone, and who pays for tail malpractice coverage. Your attorney reads these terms.

Common questions

What dermatologists ask.

Do dermatologists need a financial advisor?

Not necessarily. Many dermatologists manage well with a good accountant and some reading. An advisor tends to help most when decisions stack up: a first contract, an equity offer, loans and a house. If you hire one, ask how they're paid and whether they act as a fiduciary. How to choose a financial advisor as a doctor

How much does a dermatologist make?

BLS puts the mean for salaried dermatologists at $347,810 a year (May 2024). Owners and partners are often missing from those figures, so compare with dermatologists at your stage and in your state rather than with one national number.

Should I join a private equity-backed dermatology practice?

There's no general answer. It depends on the pay formula, what you'd own and when, and what the agreement restricts. Compare it with your other offers on the same terms, with your attorney reading the documents. Questions to ask before you sign

Base salary or production pay: which is better?

Neither in general. A base is steadier while you build a patient panel; production pay can rise with your volume. Ask how long any fixed starting salary lasts and run the numbers on a realistic first two years.

Guides

Financial planning for dermatologists