Do orthopedic, neurosurgeons feel fairly compensated in 2023?


Where orthopedic, spine and neurosurgeons live and practice can have a major impact on their compensation. 

While the average salary for orthopedic surgeons in 2022 was $557,000, that number varied by $8,973 a year on average between the East and West coasts. 

Question: Do you feel fairly compensated when considering the cost of living in your state? 

Doug Blaty, DO. Inland Northwest Spine (Coeur d'Alene, Idaho): I feel compensation is fair for covering living expenses; however, when considering massive student loans, catch up retirement (since we are in school until our 30s), increasing demand of higher wages and salaries amongst my employees, and the constantly lowering physician reimbursement, I do not feel reimbursement in my state is adequate overall.

Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: Part of what has been an issue with Medicare is that we have not had a cost of living adjustment to Medicare for at least two or three decades. So, it costs more to do business in, say, Los Angeles versus Punxsutawney, Pa. That regional variation, but also just in general, they have not given us an increase to offset the gradual cost of doing business. The short answer is no, and there is an obvious disparity between people who run the health systems and the insurance company and the people who are actually doing the care. Until that gets better, we won't see improvements to patient outcomes, patient satisfaction and the cost of doing care. The failure of Medicare to compensate fairly is part of where we are right now. 

Christine Hammer, MD. Virginia Mason Franiscan Health-St. Joseph Medical Center (Tacoma, Wash.): I do feel overall we are fairly compensated. I have seen some starting salaries which seem a bit low for the times, and actually are very similar to starting salaries 10 years ago, but with production-based pay, most of the jobs in my area are competitive and reasonable after one to two years. 

Thomas Loftus, MD. Austin (Texas) Neurosurgical Institute: No, I think that salary and reimbursement growth have continued to trail the cost of living growth in Texas every single year since I started my practice 20 years ago.

Joseph Orchowski, MD. OrthoVirginia (Lynchburg): I am in a large private practice and unfortunately, we are not fairly compensated. With increasing Medicaid population and decreasing Medicare reimbursement, compensation continues to decrease as work continues to increase. We have many patients who travel 90 plus minutes, passing other providers and hospitals in order to have care at our practice. Many of these patients are Medicaid, and they are passing practices who refuse their care. We have a sense of commitment to our community, therefore we do not exclude care based on insurance. Unfortunately, I fear that in the future this is not sustainable.

Dr. Lali Sekhon. Reno (Nev.) Orthopedic Center: Inflation is running at 6 to 7 percent. CMS reduced physician payments by 2 percent in 2023. My staff got pay raises to deal with the high cost of living. We are in Nevada. There is not a state in the U.S. where, with inflation at 6 to 7 percent, any industry would be happy with a 2 percent pay cut.

Issada Thongtrangan, MD. Microspine (Scottsdale, Ariz.): As far as I know, the cost of living in Arizona is 7 percent higher than the national average. In combination with the inflation and CMS-proposed reimbursement cut, I don't feel fairly compensated, especially being an independent physician and a business owner. I have to be creative looking at cutting unnecessary costs to be able to provide quality care and be competitive in the market.

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