The national average salary for emergency physicians increased again this past year, a full 3.5 percent. Not a stunning number, but when you add it into the trend of the past 10 years, it reflects a 34.5 percent increase for emergency physician salaries over the past 11 years.

How is it happening? States that have been chronically low-paying historically are starting to climb. In New York, for instance, starting salaries increased 25 percent this year. Even the West saw dramatic increases, with salaries up 32 percent in Nevada and 14 percent in New Mexico.

The Midwest continues to be all over the map, with increases in Michigan (11 percent), Minnesota (12 percent), and Ohio (14 percent) and a big decrease in Kansas of 18 percent. The Mid-Atlantic states experienced a 17 percent increase overall, including a 20 percent hike in the District of Columbia. The Pacific Northwest posted a 15 percent increase in Montana and 14 percent in Washington.

Another important number is the percentage of job opportunities open to physicians with primary care board certification (PC-BC). Currently, this is 43 percent! With nearly half the country’s emergency medicine jobs open to physicians not trained in emergency medicine, we have further evidence of the location-driven supply and demand market in the specialty. I see this number increasing in the next five years. You can also visit ACEP’s comprehensive archive of industry and EM-specific salary and compensation information.

Trends and developments this year include:

• Urgent care salaries are creeping up and, in some cases, pay as much or even more than emergency physician incomes in some states.
• Sign-on bonuses continue to grow, with $50,000 a norm and a high between $120,000 and $150,000 in geographically challenged areas.
• Broad salary ranges continue in some states, such as $116–$300 an hour in Pennsylvania and $160–$282 an hour in Minnesota.
• The highest dollars in emergency medicine occur in locum tenens offers, with the $300–$320 an hour appearing more frequently. I even found one location offering $350 an hour in North Dakota.
• Only eight states provide no options for PC-BC physicians this year.

The following numbers are based on working 1,632 clinical hours a year and include incentive bonuses and relative value unit compensation, where applicable. Annual package numbers include basic benefits valued at $30,000. Sign-on bonuses, loan assistance, and other perks are not included. Rankings are based on state averages, not highs and lows.

The Southeast once again leads the country with a regional average of $236 per hour/$416,000 a year. It also nearly leads the country in opportunities open to physicians with PC-BC at 54 percent, up 26 percent from last year

Mississippi: Average: $265/hr., $463,000 ann.; 50% PC-BC; high of $300/hr.; no change South Carolina: Average: $253/hr., $444,000 ann.; 54% PC-BC; high of $500,000 ann.; up 7%
Georgia: Average: $238/hr., $418,000 ann.; 71% PC-BC; high of $300/hr.; up 6%
Tennessee: Average: $234/hr., $412,000 ann.; 75% PC-BC; no real highs; no change
Alabama: Average: $234/hr., $412,000 ann.; 25% PC-BC; high of $500,000 ann.; up 10%
North Carolina: Average: $228/hr., $402,000 ann.; 51% PC-BC; no real highs; up 8%
Arkansas: Average: $226/hr., $400,000 ann.; 100% PC-BC; no real highs; no change
Louisiana: Average: $225/hr., $397,000 ann.; 33% PC-BC; no real highs; down 7%
Florida: Average: $225/hr., $397,000 ann.; 25% PC-BC; high of $350/hr.; no change