The reason American doctors make so much isn't because the system is broken—it’s because the top 1% in the US is just that rich.
March 25, 2026
Original Paper
International Comparison of Physician Incomes
SSRN · 6464922
The Takeaway
While many blame high US healthcare costs on 'greedy' doctors or medical unions, this study shows that US physicians occupy the same relative income rank as their peers in Europe. The difference is simply that the US top 1% is significantly richer than the European top 1%; cutting doctor pay to European levels would barely impact total healthcare spending.
From the abstract
We compare physician incomes using tax data from the United States, Canada, Sweden, and the Netherlands. Physicians are concentrated in the top percentiles of the income distribution in all four countries, especially in the United States and certain specialties. Physician incomes are highest in the United States, and a decomposition shows that this mainly reflects differences in overall income distributions, rather than physicians' locations in those distributions. This suggests that broader lab