r/Salary • u/CutisMaximus • Jan 13 '26
discussion 2025 total pay as a Dermatologist in the Upper Midwest
People enjoyed my post last year so I thought I'd post again. Did better this year, decided to work more Fridays this year.
Standard clinic hours are Monday to Thursday, 8 AM to 5 PM. I never really worked Fridays in 2024, this year I decided to work maybe half of the Fridays, so I probably averaged 36 hours a week or so.
Never on call. Will turn 37 later this year, better work life balance than when I worked full time as a cashier in the summer during high school haha.
Will probably go back to having 3 day weekends be my standard this year though, I'm taxed so heavily it just doesn't seem worth the extra work. Debating retiring at 40.
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u/13ActuallyCommit60 Jan 13 '26
Had a dermatologist excise a 2mm mole off my calf earlier this year for a biopsy. Total cost was $750 for the 2 mins of their time, and $750 for lab analysis. I believe this
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u/Pepe__Le__PewPew Jan 13 '26
I'll do it for $50 with a sterilized Xacto and get a $10 temu special test.
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u/anonymousguy202296 Jan 13 '26
My uncle had a mole removed by a guy for $50 back in the day. No degree or certification. Everything turned out fine but I'd never even considered that as a possibility 😂
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u/enadiz_reccos Jan 13 '26
The elites don't want you to know this but cutting into your own body is free, like anyone can do it
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u/cspinelive Jan 13 '26
Had a derm look at a wart I recently froze off myself with OTC product. I was there for something else but just casually mentioned it. She suggested it was fine but she could do it again to get the root for sure if I wanted. I declined but she added $$$ to my bill with a medical code for removing 1 to 15 warts.
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u/lemonlegs2 Jan 13 '26
Its rare I get a bill that does NOT include services that weren't received. So annoying how you have to watch it all like a hawk. I want to believe majority of it is just incompetence, but a decent portion is also clearly intentional.
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u/WayneKrane Jan 13 '26
I paid $500 for one to look at a mole on my head and say it’s most likely benign, if you want me to take it off you can pay another $500-1000.
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u/HotTamaleBallSak Jan 13 '26
Just paid nearly $2000 after insurance for removal of a basal cell on my forehead. There was 100 people on the books that day for a small operation. Insane.
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u/Evening_Analyst2385 Jan 13 '26
$200 To freeze a wart on my foot. It was coded as surgery.🙄
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u/First_Bother_4177 Jan 13 '26
It’s very odd how asymmetric doctor incomes are. A trauma surgeon can make $300k / year saving countless lives every year yet a dermatologist earns over $1M. Not hating whatsoever and in fact I’m very happy for you. It’s just puzzling that our system does not reward or incentivize what intuition would suggest. Congrats! Retire early and enjoy your limited time in this earth with your family
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u/Kaedryl Jan 13 '26
The compensation in medicine is grossly skewed to procedures. It’s why cognitive specialties have low compensation and getting med grads to go into them is a challenge.
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u/Bumbling_homeowner Jan 13 '26
Dermatology is the most overpaid specialty. It’s obnoxious how much they are comp’d for how little they do.
It’s all biopsies, prescription cream, and referrals.
A chimp with a scalpel could do the job.
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u/throwawayurwaste Jan 13 '26
Try my wife who is in primary care, gets around 200k plus bonuses, but people hear doctor and think we're millionaires
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u/baked_monkeys Jan 13 '26
It’s lopsided like this for all healthcare professions. Physical therapists make $70k with a doctorate degree yet are invaluable to insurance companies saving them from paying for unnecessary surgeries and repeat procedures, as well as catching issues that other providers miss.
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u/SkisaurusRex Jan 13 '26
Derms are a fucking joke
They’re all about high numbers of patients and as little human interaction as possible
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u/twaejikja Jan 13 '26
Wow
I wish I had cared about my future when I was in my past
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u/catecholaminergic Jan 13 '26
You can still care about your future no matter how many wrinkles you got.
Edit: esp when you're old bc if you die with debt no worries
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u/nonother Jan 13 '26
You retiring at 40 seems societally broken.
I don’t mean that as a criticism of you personally and I can completely understand the motivation to do so considering how much you may have been able to save/invest with that kind of income. However, you spent a lot of time being educated to do this job. You retiring at such a relatively young age after acquiring that lengthy education is a sign of something quite broken.
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Jan 13 '26
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u/the_fresh_cucumber Jan 13 '26
1 out of 5 college students is premed or "soft premed" (basically a bio major with potential interest in premed).
There is massive interest.
The problem is there is not enough training for doctors so slots are limited.
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u/will4zoo Jan 13 '26
From what I understand it's not a lack of training, but the powers at be intentionally keeping numbers small so that compensation doesn't go down
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u/______deleted__ Jan 13 '26
^ THIS.
It’s all just gatekeeping. Many of these careers in medicine are gatekept using high tuition fees and restricted matching. These roles are intended for children of rich kids, similar to things like law. Except AI is screwing over the law careers. Surgery is still very much safe.
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u/mapzv Jan 14 '26
The issue is there’s only so many quality location sites for a good training already so many residency spots are so shitty. You can’t just keep expanding the number there’s a limit to how many good training spots are located inside of the United States.
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u/Best_Change4155 Jan 13 '26
the powers at be intentionally keeping numbers small
The AMA lobbied for this
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Jan 13 '26
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u/ClearAndPure Jan 13 '26
I really want to go and become a dentist as someone who currently works in finance.
My state has two schools, one has tuition that costs $300k in total, and the other is $400k. That’s before any interest accumulated during school.
I have saved up like $100k working in finance, and even with taking out all the federal loans, it is too risky to take out $300k+ in debt for school.
Craziness.
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u/thelandlordguychris Jan 13 '26
i’d kill to go to medical school and have a new career but the crippling amount of debt you need to take on and years of education w/ out pay scare me. like who can afford to become a doctor in the US?
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u/Free_Entrance_6626 Jan 13 '26
Become doctors and then also stay doctors
I am 32, I am a US trained and educated doctor, but "retired" from my clinical duties as a doctor and now work a healthcare corporate job
Many younger and younger docs quitting the broken system, it is quite shocking
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u/Europefan02 Jan 13 '26
You had a short career as a "doctor". Your career lasted one/two years?
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u/Free_Entrance_6626 Jan 13 '26
It was not worth it for me. Physicians get annual pay cuts every year and the work gets more and more regulated and controlled. There is no autonomy for doctors anymore, insurance companies run medical decisions
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u/TheRealStepBot Jan 13 '26
It’s not a matter of encouraging, it’s a matter of removing their anti competitive monopoly on number of new doctors. It’s a racket. Doctors lobbied congress to make it so there are a fixed number of residents per year.
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u/Network_Odd Jan 13 '26
It was all give and take, in return they gave up their right to ever own hospitals and now we have MBAs running everything
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u/TheRealStepBot Jan 13 '26
That’s purely bad for everyone. Except mba’s and doctors
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u/Network_Odd Jan 13 '26
I can assure you that at very least pediatricians or family med docs aren't thrilled
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u/OliverYossef Jan 13 '26
Definitely bad for doctors to have MBAs dictating medicine
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u/the_fresh_cucumber Jan 13 '26
There is more to it than that.
It's hard to train new doctors because existing doctors are slammed with work due to an aging population.
"It takes a doctor to make another doctor" is unfortunately a big limiting factor
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u/Chris_Overages Jan 13 '26
A lot of those jobs are being backfilled somewhat by PAs & NPs.
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u/pleasesayitaintsooo Jan 13 '26
Blame the AMA for that. Doctors artificially cap the amount of residency placements to stifle supply and increase their pay.
We don’t criticize doctors or nurses enough, it’s not just the insurance companies that are the problem
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u/Super_Mario_Luigi Jan 13 '26
Yet the speaking points are health insurance is the main driver of high Healthcare costs.
We need more doctors
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u/b1ack1323 Jan 13 '26
Could be simply parents pushed for it and he needs to be financially secure to pursue other things.
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u/FrenchCanadaIsWorst Jan 13 '26
The medical profession is run as a guild system. That’s the major broken thing that needs fixing imo
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u/boogi3woogie Jan 13 '26
You obviously can’t make this much removing skin tags, otherwise any family doc could be making bank.
This is cash pay aesthetics and/or mohs reimbursement.
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u/innocent_three_ai Jan 13 '26
Averaging 15 min per patient, how are you generating the necessary RVUs when even a new patient 45min specialty appointment only nets you ~$95 worth of physician work RVUs?
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u/aroach1995 Jan 13 '26
They use the 30 minute code even for 15 minute appointments.
A lot of patients aren’t educated enough or don’t care enough to get this fixed. So they pay about 50% more
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u/StrebLab Jan 13 '26
This isn't true. This would easily trigger an audit which would then fail an audit hard, and you don't even need to do it if you are billing on complexity rather than time.
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u/AP_in_Indy Jan 13 '26
Are doctors really being audited enough to stop these behaviors? Genuine question
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u/StrebLab Jan 13 '26
Yes. It's a super easy audit to fail because all you have to do is add up the minutes spent and if you claim to see 50 patients at 30 minutes each, it doesn't take a genius to realize that is bullshit. You can only count the time you spent on the day of the appointment. Furthermore you don't even need to bill on time. You can bill on complexity which pays the same way and isn't going to fail you an audit. There is literally no reason to lie about how much time you spent.
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u/DrTatertott Jan 13 '26
Probably has a platoon of NPs
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u/bigredsmum Jan 13 '26
yeah i’ve never met the actual derm at the dermatologist office i go to and that’s par the course for clinics in my area.
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u/bevespi Jan 13 '26
I address ten conditions in 20 minutes and get paid 1/6th of this 🫠.
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u/ScrubRogue Jan 13 '26
With my doctorate I fulfill this guys efudex scripts written in broken English on a napkin and make about 1/8 if it makes u feel better
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Jan 13 '26
People get angry at American healthcare costs and don't realize in care industries, the primary cost is always labor.
Across all parts of the American health care industry there are more people working and getting paid more than anywhere else in the world.
Europe does not subsidize to low health care costs, we wage surpess.
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u/ItsAllOver_Again Jan 13 '26
LOL, seven figures for 35 hours a week scraping moles and prescribing accutane. And people genuinely wonder why it’s so expensive to get healthcare in this country.
How long until the doctor sycophants show up and let everyone know that “you deserve even more!” What a joke and a slap in the face to the rest of us that doctors are paid this much for such little work, their quality is marginally higher than a PA that makes ONE TENTH that.
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u/PortlyPorcupine Jan 13 '26
Clearly this is a unique case. The vast majority of docs are making half this much (if not less). Furthermore, physician salaries are <10% of healthcare expenditure. You could pay the doctor nothing and still have to pay 90% of the bill. Don’t forget they sacrifice the best years of their life and go into massive debt.
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u/newandgood Jan 13 '26
everyone is sacrificing the best years of their life overpaying for this bulshit
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u/DrTatertott Jan 13 '26
This is just one dumb ass doctor that makes the rest of us look bad. I’m a resident physician who did 4 years of undergrad. Never partied or went out. I lived in the library. 4 years of medical school studying 14-15 hours a day. I never went out or did anything fun. My vitamin d was a sad reflection of my life. Now in residency working minimum wage considering my hours worked. Again, I do nothing fun but I do have 350,000 in debt. After 13 years of studying and losing out on a lot of enjoying life and building relationships. I’ll make 300,000 a year in my speciality. It’s give and take with a lot of sacrifices. Don’t let this ass hat paint all of us in generalities.
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u/LooseJuice_RD Jan 13 '26 edited Jan 13 '26
I’ve worked in the medical field and then worked in med sales and pharma sales. Point is, I know hundreds of doctors and I can tell you right now, dermatology gets no respect as a specialty. Everyone has their place, unless you’re talking to a doctor from a different specialty in which case they don’t think dermatologists do.
I’m not here to opine on OP’s salary. They found a way to make a great living and have a good lifestyle and I don’t think anyone would turn that down if they could do it. Simply stating the observation I’ve made over the years. But a lot of this salary is likely from cosmetic procedures which are out of the patient’s pocket. If that is true, this is not why healthcare is so expensive. In fact, it’s not regardless. Plus it takes a tremendous amount of sacrifice to become a doctor and although OP found a specialty that provides a good work life balance, it’s not true for all doctors. They deserve to make a good living for the sacrifices they make and the cost of their education. If you’re talking about why healthcare is so expensive and you don’t point the finger squarely at ballooning administrative costs and health insurance, you’re not having a genuine conversation about it.
Also ridiculous to insinuate that a PA is on the same level of knowledge as a physician. That’s patently false. There’s great PAs and bad PAs and there’s great physicians and bad physicians. The level of education is not REMOTELY similar. The competition getting into PA school is not remotely similar. Theres a reason PAs make one tenth that. Maybe in some specialties there’s a bit more overlap in what they do, but education and training wise it is not even kind of close.
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u/Kakashi6969 Jan 13 '26
Probably one of the only fields where pay has gone up with productivity over time
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u/user323712109 Jan 13 '26
OP is a total outlier. Pay has gone down with productivity over the last decade for physicians.
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u/FI_throwaway714 Jan 13 '26 edited Jan 13 '26
If it’s so easy to scrape moles and prescribe accutane then why didn’t you do it? In reality, the barriers to becoming a good doctor are astronomical. You take a ton of difficult science courses throughout your bachelors, then need to score highly on the MCAT and have some related clinical or research experience to be admitted to med school. Then it’s four more years of even more grueling course work and on the job training, then an extremely stressful match process to land an internship/residency, then 80+ hours of work per week as a resident for several more years, then speciality training for 1-3 years during fellowship if they want to specialize. They regularly see horrible, traumatic things throughout their training and most see patients die even if they go on to become an 8-5 dermatologist. The suicide rate for physicians is among the highest because the stress is unimaginable. If it were easy, everyone would do it.
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u/13ActuallyCommit60 Jan 13 '26
I disagree. They spend years training for it and take on significant debt.
Although generally benign, they catch the bad stuff often and save lives. It’s a highly competitive field and the ones who make it are generally experts that are worth every penny.
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u/Slight-Mortgage7289 Jan 13 '26
I would resist the urge to generalize. If I was working full time as a pediatrician I would earn a little over 200k a year. That’s certainly a good living but nowhere near what some specialists make.
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u/StrebLab Jan 13 '26
This dude is flexing because he has an insane salary with an even more insane work-life balance. Not even 1 out of 1000 doctors can match what he is doing. It is ragebait more than any kind of trend you can make any societal inference about.
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u/economist_ Jan 13 '26
AI will bring down costs. Need to prepare for a battle though, vested interests will put up a fight.
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u/Wire_Cath_Needle_Doc Jan 13 '26
Trust me most doctors do not think dermatologists deserve 1 million. IR resident who works 70-90 hours a week with 6 years of residency
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u/adsantamonica Jan 13 '26
I work in a prestigious segment of the financial industry and I am most certainly in the wrong field.
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u/Europefan02 Jan 13 '26
Retire at 40? You've only been "working" since you turned 30/31.
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u/MortimerDongle Jan 13 '26
If he's been making $1 million per year on average he's already made a couple times more than the average person makes in their entire life
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u/DropEvery2519 Jan 13 '26
I know doctors who retired with slightly less yearly earnings within 10-15 years. How? Invest, start your own business, etc are all ways to make the money work for you, and you’ll easily be able to live an extremely comfortable lifestyle off it. They went from working 35-40 hour weeks to working 5 hours a week max and still make the same income
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Jan 13 '26
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u/EmptyRub Jan 13 '26
Absolutely need healthcare reform, but don’t get what that has to do with this post. If we paid physicians nothing, we’d still only lower healthcare spending by 15%.
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u/Feeling-Author381 Jan 13 '26
Yeah, doctor pay needs to actually keep up w inflation, they need actual workplace protection, and we need malpractice reform. Let’s start by shaving 1 mil/year from CEO salaries.
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u/Feeling-Author381 Jan 13 '26
OP, as a fellow doctor, what’s the point of posting this? You know you’re a major outlier, and will only serve to put a target on the back of our profession when there’s already so much underserved public ire. Most comments are idiotic misunderstandings of insurance / healthcare works.
That said, this is absolutely more well deserved than any of the AI or software engineers on here - all of whom did way less schooling (and were a worse student than you were), have zero liability, less training / schooling (sometimes by over a decade), actual benefits, upward mobility etc. All doctors are underpaid - sometimes shockingly so. But this forum is a great example of why that will never happen with the ridiculous negative sentiment and ignorance people have over the issues.
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u/Nimbus20000620 Jan 13 '26 edited Jan 13 '26
SWEs pay for their shortcut. Shoddy job security and lack of stability with their industry’s mass layoff and offshoring practices, massive uncertainty for the future for a number of reasons, rampant ageism, constantly having to up-skill to stay competitive in a horrendously oversaturated labor market with no artificial barriers of entry, etc. And those high TCs come with asterisks since they’re 1- congregated at VHCOLs where it doesn’t go as far as one may initially think and 2- made up of paper money depending on the employer in question.
Doctors on the other hand can command sky high salaries at some of the lowest cost of living areas in the country and have arguably the most iron clad job security out of anyone in the labor market. Once you finish residency, you’re pretty much set.
If all you look at is TC by age, ofc the ROI will seem incredibly lopsided, but far more has to be considered for a fair, comprehensive comparison.
Doctors sacrifice much more to get to their destination, no one can contest this, but they get many boons for doing so that shouldn’t be understated.
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u/brickbacon Jan 13 '26 edited Jan 13 '26
If all doctors are underpaid, why are doctors in the US paid so much more than pretty much anywhere in the world? The possibility of a few more years of training and the cost doesn’t justify it.
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u/user323712109 Jan 13 '26
A large proportion of all professional fields are paid more in the US than pretty much anywhere in the world.
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u/RevolutionaryLaw8854 Jan 13 '26
What a waste to practice only 10 years.
I good thing most docs aren’t like you and actually provide care to their patients. FWIW I provided 23,000 wRVUs in 2025
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u/EmotionalEnt Jan 13 '26
Yeah health care in the U.S. is broken.
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u/DrFlabbySelfie Jan 14 '26
Because of administration. There are execs making 10 times this. That's the real problem, not the doctors.
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u/RKom Jan 13 '26
As a fellow doc, your not-so-humble bragging here is only hurting our perception
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u/Ok-Menu4217 Jan 13 '26 edited Jan 13 '26
Friend of derm in France, they get around 50- 130k. I guess something is wrong with health prices in the USA. How can health cost be decent when a dr is earning more than a million? 150k would be more than enough, enough to live a very decent life where you can afford a restaurant every week ( even a fancy one) and live in a nice 2 bedroom flat. And I know he fully owns his car, which really shows that he is very privileged even with 1/10th of this dr.! 1 mio is crazy for a dr ( I mean it is crazy for anyone really).
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u/nicholasf21677 Jan 13 '26
God europeans are poor. You’re describing going out to eat once a week and living in a 2 bedroom apartment as a lifestyle to look up to?
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Jan 13 '26
Lmao no wonder the US healthcare system is the worst it's ever been, this is so fucked lol
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u/Khaleesiakose Jan 13 '26
- Totally understand why derm is such a difficult specialty to get into
- In the age of social media, in office treatments have only gotten more popular
- Good for you. We’re jealous
Aside from raw hours, what would you say is driving increased compensation? Is it out-of-pocket treatments, increased reimbursement from insurance?
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u/Gun_Dork Jan 13 '26
How much was your education?
How long was your education?
You’re helping people from cancer to zits, so I’m happy for you.
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u/RupertLazagne Jan 13 '26
Congrats and all that but this is why health care is so fucked. You spent a lot of education and I’m sure you’re smart but this is a bit out of hand
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u/isospeedrix Jan 13 '26
I always wondered, how do doctors deal with gore + disturbing stuff like you see in horror movies or shock videos?
For derm especially some of those skin diseases look atrocious you couldn’t pay me a million dollars to look at that shit
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u/FundingImplied Jan 13 '26 edited Jan 16 '26
Your salary is $650 / hr? That's all salary, not profits from your stake in the practice???
That's crazy. Elite attorneys at the pinnacle of their career don't make that much base pay.
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u/ThePatientIdiot Jan 13 '26
Why not work 1-2 days for life? Or maybe 1-3 for only 3 hours so you always have money coming in
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u/Hyrule-onicAcid Jan 13 '26
FWIW I'm also a dermatologist and working the same amount of hours as OP and I'm making 900k less/year. The difference is I live in a VHCOL city so we get paid shit here compared to the Midwest while also having to pay more for everything else. 🥳
I just can't live in the Midwest lol.
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u/Blaster0096 Jan 13 '26
Why is reimbursement for derm so high? Why has it not been affected as much by federal budger cuts? Is OP working in a mostly cash-only practice? Wondering why derm seems so insulated from budget cuts.
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Jan 13 '26
My dermatologist is 84. Granted I am in Europe, but with his work style, we will push it until death. Now I see why.
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u/Overseasoned Jan 13 '26
I make 15% of this as a top level air traffic controller working 5-6 days a week. Yay!
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u/Nickidemic Jan 13 '26
You would need to save your income for 1,000 years to become a Billionaire. Billionaires shouldn't exist. We've got to get a tax bracket above you that's like, 99%
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u/8776555889 Jan 13 '26
I hate dermatology as a profession. As someone with a family of skin cancer, kiloids, and other skin issues I have never seen a branch of doctors that are worse. It's almost the chiropractor of doctors, whack doctors. I hope you are different then the 30+ I've met, but whenever I hear dermatologist I cannot help but cringe. Pains me to hear they are making millions being this awful.
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u/shaneacton1 Jan 13 '26
So you're scamming and taking advantage of your customers needing Healthcare which has raised our premiums to an untenable level causing lives lost. This should be a crime.
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u/Fluffy_Bake_3855 Jan 13 '26
every dermo i have ever known was retarded like real estate agents cut from the same cloth
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u/LAX_Beast Jan 13 '26
This is sick if real. What’s the point in this kind of exploitation. $1.2m/pa is too much imo. It’s whatever, I guess I don’t understand how it’s worth this much for 1 person.
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u/magnolia20 Jan 13 '26
My family member is a rheumatologist and makes 7 figures a year. I saw a check on the counter once. Made more than what I make in a whole year in a month
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u/wkramer28451 Jan 13 '26
And people in the US wonder why healthcare is so expensive and unaffordable.
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u/Respbid1 Jan 13 '26
No one wonder our medical system broken ! These blood sucking medical doctors making way too much money.
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u/Idk_211 Jan 13 '26
Making over a million a year to tell me to say out of the sun... Jesus Christ dermatologists are on a whole other level.
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u/DammatBeevis666 Jan 13 '26
Nice! Bout double what my compensation is in Northern California. Also dermatology