GeneralCOMMENTARY

The hospitalist’s paradox: on pay, perception, and the true value of a healer in the valley of the sun

Gary P. MacDonald, DO, MS, FAAFP
Notes and Affiliations
Notes and Affiliations

Received: May 13, 2025

Accepted: August 11, 2025

Published: August 28, 2025

  • Gary P. MacDonald, DO, MS, FAAFP, 

    Department of Osteopathic Principles & Practice, Rocky Vista University College of Osteopathic Medicine, Ivins, UT, USA

Abstract

This article examines the sentiments of a Phoenix-area hospitalist who feels underpaid despite earning an objectively high salary. While physician compensation in the United States, including that of hospitalists (around $365,000 in Phoenix), ranks among the highest globally and places them in the top income percentiles domestically, the perception of being “underpaid” persists. The piece argues this feeling is a complex value judgment, influenced by the immense effort, sacrifice, and societal contribution inherent in the profession, often perceived as inadequately reflected by market-driven compensation. Cognitive biases, such as the Intrinsic Worth Fallacy and Social Comparison Bias, further shape this perception. Systemic healthcare issues, including administrative burdens and professional disempowerment, also contribute, leading to dissatisfaction where salary becomes a primary, yet seemingly insufficient, metric of worth. The article concludes that true professional value transcends monetary figures, calling for systemic changes to better acknowledge and support physicians, ensuring their profound contributions are recognized beyond financial metrics.

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