Plastic Surgery Tops Israel’s Doctor Pay Rankings, but the Picture Is More Complex

A new Finance Ministry chief economist study says plastic surgery is the most lucrative medical specialty in Israel’s public health system, with an average annual income of 1.12 million shekels in 2023. The analysis examined 4,636 specialist doctors employed by government hospitals, combining public and private earnings. It found that only about 333,000 shekels of the plastic surgeons’ average income came from public medicine, far below the overall average of roughly 523,000 shekels from public work.

The report says plastic surgery, dermatology and ophthalmology are the three specialties that receive the least income from the state and rely heavily on private practice. In plastic surgery, about 73% of total income comes from private medicine. The researchers note, however, that after adjusting for other factors, anesthesiologists and thoracic and cardiac surgeons actually earn more on average than plastic surgeons and dermatologists. They say the high averages in those specialties are distorted by a small number of extremely high earners in very small fields of roughly 30 to 40 doctors each.

Thoracic and cardiac surgery ranks third in total income, but first among specialties that depend mainly on public-sector pay. Anesthesiology and nuclear medicine also generate strong public-sector income, while orthopedics and ear, nose and throat stand out for private earnings. At the bottom of the scale are pediatrics, oncology, psychiatry, neurology and internal medicine, which have relatively low salaries and little private income. The report cautions that the 2023 data predate the post-October 7 surge in demand for psychiatry, which has since improved pay.

The study also found strong concentration at the top of the salary ladder in Sheba Medical Center and Ichilov Medical Center. Together, doctors from those two hospitals make up more than half of the top two income deciles, but only about 40% of the bottom three. Among all government-hospital doctors, the average annual salary was about 772,000 shekels, with 524,000 shekels from public work and 248,000 shekels from private practice.

OECD data for 2023 show that Israel’s salaried specialist doctors earn about three times the average wage, placing the country ninth among OECD members. The report says the lower ranking compared with 2015 largely reflects statistical changes, including South Korea’s addition to the comparison, Hungary’s wage reform and rising Israeli average wages. It also found that doctors in peripheral hospitals earned about 836,000 shekels on average, roughly 10% more than doctors in the center, mainly because of a 2011 wage agreement that added about 20% for peripheral doctors. However, research-fund income was much higher in the center, 154,794 shekels versus 61,354 shekels in the periphery. The report concludes that despite the 2011 pay deal and the related reform intended to reduce doctors’ dependence on private medicine, major gaps between specialties and between government-hospital doctors and the broader market remain.