In our last post, Does Higher Physician Compensation Really Lead to Greater Satisfaction?, we explored the nuanced relationship between pay and satisfaction with pay. The key takeaway? More money doesn’t always mean more satisfaction with pay. Satisfaction with pay is shaped by a number of factors, including the hours worked, benefits, practice type, and how you compare to your peers. But there’s one factor that is probably more important than anything else: your location.
Where you practice matters. Most physicians become deeply rooted in the communities they serve, and their satisfaction with pay is influenced by the cost of living, the lifestyle they can sustain, what it's like to raise a family in that location, in addition to whether their work feel valued in that setting.
In this post, we dig into thousands of physician salary submissions on Marit to explore how geography - both across states and metro areas affects satisfaction with compensation.
State-Level View: Satisfaction ≠ Salary
Pay Satisfaction is measured on a 5-point scale, with 1 representing Very Dissatisfied with Compensation and 5 representing Very Satisfied with Compensation. When we mapped average satisfaction with pay by state, the differences are stark.
The nation-wide average is 3.59★
The Northeastern states stand out as clear outliers. Despite offering access to many prestigious institutions, these states often report below-average salaries alongside some of the highest costs of living in the country. That combination likely contributes to lower satisfaction scores. For example, pay satisfaction in New York averages 3.4★ (see Physician Salaries in New York), Massachusetts 3.53★ (see Physician Salaries in Massachusetts), and Pennsylvania 3.44★ (see Physician Salaries in Pennsylvania) - all below national averages.
On the West Coast, the pattern holds in a slightly different way. Physician Salaries in California are much above average, but satisfaction is only slightly above average at 3.62★ (see Physician Salaries in California), likely reflecting the challenges of practicing in a high-cost, high-regulation environment. And Hawaii, while being a highly desired state for tourism, pays much below average and has one of the lowest pay satisfaction rates of 3.32★ (see Physician Salaries in Hawaii). New Mexico is another state that ranks near the bottom in terms of both average total compensation and pay satisfaction ratings - 3.29★ (See Physician Salaries in New Mexico).
By contrast, several lower-cost states report higher-than-average satisfaction, even when nominal salaries are more modest. Physicians in Iowa, Utah, and Georgia consistently rate their compensation more favorably, suggesting that quality of life, and perceived fairness, rather than total pay, may be driving satisfaction.
On the high end, Nebraska leads the nation with an average satisfaction score of 4.13★ (Physician Salaries in Nebraska). Other states with similarly high satisfaction include Indiana (3.9★), Arkansas (3.9★), and Nevada (3.95★). What these states have in common is a mix of competitive compensation and a more affordable cost of living, creating an environment where physicians feel they are fairly paid for the work they do.
See - Physician Salaries in Indiana, Physician Salaries in Arkansas, Physician Salaries in Nevada
Which states break the pattern?
Ranking states by average total compensation, we can see that higher pay tends to correlate with higher satisfaction - but not always. Several states break that pattern.
One of the most interesting outliers is Maine - the only Northeastern state with significantly higher-than-average satisfaction. This may be driven by a mix of smaller community-based systems and a relatively lower cost of living compared to its neighboring states (see Physician Salaries in Maine).
Colorado stands out for reporting above-average satisfaction despite offering below-average pay (see Physician Salaries in Colorado). It's home to large academic and integrated health systems, where compensation may be lower but comes with better benefits like work-life balance, and great location appeal.
On the flip side, Arizona reports lower satisfaction despite offering higher-than-average pay. According to a Survey conducted by Gallup Arizona, only 52% of Arizonans expressed satisfaction with the availability of healthcare specialists in their communities. See Physician Salaries in Arizona here
Another interesting contrast is Georgia vs North Carolina. Physician Salaries in Georgia are almost 20% higher than Physician Salaries in North Carolina, but the satisfaction with pay is lower (3.59★ vs 3.69★). This may be because Georgia has more large-scale private equity-backed groups, which may emphasize higher productivity over autonomy. See Physician Salaries in Georgia, Physician Salaries in North Carolina
Help us bring transparency to medicine
Metro-Level Insights
State-level trends are helpful, but the metro-level view is where things really get interesting. Let’s take a closer look at how satisfaction with pay varies across different cities.
Each circle on the map represents a metro area. The size reflects how many physician salary submissions we’ve received for that city on Marit, and the color shows average satisfaction with pay, from dark green (highest) to red (lowest).
While, as a general rule, large metros report lower than average pay and satisfaction than smaller towns, the most notable example of this is New York City - with one of the lowest pay satisfaction rating (3.34★). On the other hand, there are several that report very high levels of satisfaction, e.g., Las Vegas, NV, Cincinnati, OH and Louisville, KY have very high pay satisfaction rates (higher than 3.8★).
While there are general patterns at state level or even at the city type level - e.g., on an aggregate basis, Rural areas have higher pay satisfaction than Metro areas, there is a lot of variance across Metros, even within a state. e.g., Orlando, FL has an average physician salary of $417k and pay satisfaction of 3.8★, whereas Tampa, FL has an average pay of $335k and pay satisfaction of 3.3★. Similarly, on the West coast, Los Angeles has an average pay of $427k and pay satisfaction of 3.55★, whereas neighboring San Diego has an average pay of $423k and pay satisfaction of 3.37★.
Visualizing the Metro Areas ranked by average pay below shows that the relationship between pay and pay satisfaction at the metro level is much less direct, suggesting that there are many other factors like cost of living, quality of life, community and local factors at play.
Top 20 States with Highest and Lowest Physician Pay Satisfaction
Top 20 Metros with Highest and Lowest Physician Pay Satisfaction
What This Means for Physicians
If you’re a physician weighing job offers, it’s worth thinking beyond the paycheck. Where you live and work influences:
- Your cost of living
- The quality of life and the connection to the community
- The transparency of your compensation model, and how fairly you feel you’re being paid
- Your autonomy and administrative burden
For employers and health systems, this data is a reminder: compensation satisfaction is about more than just market rates. Transparent pay structures, open communication, and cost-of-living alignment are real levers for improving satisfaction and retention.
Help us build the Benchmark
This analysis is powered by anonymous salary sharing data from thousands of physicians and advanced practice providers across the U.S. As the dataset grows, so does the quality of insight. Help us build the most robust clinician compensation data-set so we can all advocate for fair pay in medicine.
Submit your salary anonymously
And if you found this helpful, please share it with a colleague. This community and data-set only gets better and more useful for all of us, as more people join.
About the Data & Methodology
Marit's Data is different. It is -
Unique - since it captures the compensation data along with all the details that matter - bonuses, shifts, schedule, benefits, and more
Comprehensive - Across all specialties and Professions (Physicians & APPs), Employer Types (large and small, including Self-employed, Academic & Non Academic), Job Types (Full Time, Part Time, PRNs and Locums) and Employment Types (W-2, 1099, K-1)
Current - Unlike other benchmarks that only update their data once a year, all salaries reflect the clinician’s current compensation, and all averages are updated in real-time as new salaries are added
All data in this report comes from anonymized salary contributions on Marit, as of May 11, 2025. Only verified salary reports approved by our moderation team are included. For States with <25 contributions, their averages were smoothed with the Region they belong in using a weighted average model. Only Metros with at least 25 contributions were included in analysis.
Want to collaborate?
If you have any suggestions or requests for customized analysis, or would like to to do deep-dive - we'd love to hear from you
References
https://www.arizonafuture.org/news-events/news/2024/12/3-facts-about-arizonans-health-care-access-and-satisfaction
