2015 Physician Salaries- Some are up, most are down!

While some physician compensation packages are increasing most are decreasing!

Take a look!

Regional Differences

The Northeast and Mid-Atlantic states had the lowest average physician salaries at $253,000-$254,000, while the best paying region was the Northwest at $281,000.

"The top earning states are North Dakota, Alaska. Pay tends to be lower in major metropolitan areas where there are more doctors competing for jobs.

Orthopedic Surgeons

Orthopedics remained the top-paying medical specialty for the third year in a row. The Medscape survey found orthopedists earned an average of $421,000 for patient care in 2014.

In addition, orthopedists earned more than any other type of physician for non-patient care activities such as speaking engagements, product sales, and serving as expert witnesses -- another $29,000 a year, on average.

Cardiology

Cardiology was the second-highest paying medical specialty in 2014, with average compensation of $376,000 for patient care plus $19,000 in non-patient care earnings.

While medical specialties like this remain lucrative, Kane says the economic incentives in medicine are shifting.

"Everything is happening because all of the efforts to lower the cost of health care to society and keep Medicare payments down," she said. "There's an effort to move from fee-for-service, where a doctor gets paid for each visit or procedure, to different types of payments structures like bundled payments for episodes of care. So for example if a patient is in hospital for heart attack, and lots of doctors work on that patient, many people are involved, but the hospital gets one payment for that patient and that has to be divvied up among many people."

Gastroenterology

Gastroenterology moved up a notch to #3 on the list, with average compensation of $370,000 for patient care and another $14,000 in additional earnings.

Anesthesiology

Anesthesiologists made an average of $358,000, making this the fourth-highest earning specialty on the list.

Plastic Surgery

Plastic surgery rounds out the top 5 highest paying specialties, with average earnings of $354,000 for patient care and another $26,000 for non-patient care activities. The specialty has steadily moved up from tenth place on the list five years ago.

Family Practice

Down towards the bottom of the list, family medicine practitioners remain among the lowest paid physicians, averaging $195,000 a year. However, they've seen an increase of about 10 percent since 2013.

"Because of the Affordable Care Act, there was a 10 percent bonus in Medicare payments to primary care physicians, basically to help elevate their pay because they expected a lot more patients going into the system once the exchanges were set up," Medcape's Leslie Kane said. "But primary care pay is still down there, it's still one of the lower paying fields."

Pediatrics

Out of 26 medical specialties surveyed, pediatrics was the lowest paid, with an average compensation of $189,000.

Regional Differences

The Northeast and Mid-Atlantic states had the lowest average physician salaries at $253,000-$254,000, while the best paying region was the Northwest at $281,000.

"The top earning states are North Dakota, Alaska -- they're trying to get doctors to come there," Kane said. Pay tends to be lower in major metropolitan areas where there are more doctors competing for jobs.