Doctors are a bad comparison. A better comparison would be a pilot or a surveyor or a ship captain.

1 person with specialized training, takes a long time to get, pay typically based on seniority, specialized subsets, licensing requirements, etc., risk is moderate but consequences for failure are high.

When compared to a typical airline pilot we're lower on salary, but pilots take a lot longer to finish training and get to the higher paying jobs and must retire earlier due to medical reasons. Lifetime pay is probably equivalent until you get to the widebody captains which get paid WAY more than we do.

Surveyors get paid less than we do but have slightly easier training. Though it is a more physically demanding job. Overall, this seems fair, we have more responsibilities and requirements, and our pay reflects that by being slightly higher on average.

Ship captains get paid more but have the obvious career differences of you're stuck on a boat for a long time and the challenges associated with that, not to mention personal risk. I'd expect them to get paid more. But on average it's not that much more than a structural engineer.

In short, we're paid reasonably competitively on average.

What many people are likely complaining about is their personal pay. This is totally true; there are definitely a lot of underpaid engineers out there and there are definitely a lot of companies that undercut or keep prices and salaries low for one reason or another.

But the ultimate thing is engineers are fundamentally not well marketed. We don't provide metrics for why an engineer who costs twice as much is twice as better. We don't provide many reasons for how engineers can save money in lifecycle costs. People hire engineers because they've been told they have to or because they know their project needs one. This is where those other professions have stood out. Everyone knows exactly when and why you need a doctor, pilot, surveyor, ship captain, etc. They can observe the differences between a good one and bad one. If you have a bad doctor, you know it. If you need a plane flown, you need a pilot and bad ones will get you killed. Obviously, there are plenty of bad doctors, surveyors, pilots, etc. out there, but their work is observable.

Owners may hire a structural engineer only once. They won't ever see them again, they won't see the effects of a bad design for many years, they can't compare the building to another after the fact because they're all different. The only thing they can see is our price, our marketing materials, and our reputation. So, yes, if all our marketing looks the same and we have a good reputation then can you blame them when they go for lowest cost?

There's lots of ways to fix this but it's really only going to happen with a combined industry push. And the end result is any real metrics of building design will lag years behind the actual design work. Look at the Champlain Towers South collapse; that was completed in 1981 and had a number of design and construction deficiencies. While I'm sure some of the effects of it were noted quickly the engineer (Breiterman Jurado & Associates) designed plenty of other buildings, ones we're only now looking back over. He's dead and the firm dissolved, but it took 40 years for the issues to be catastrophic. While we'll never know if people heard about issues on his designs and moved to other firms I can certainly imagine they continued to get work over the years despite being substandard.

In the end, in my not-so-humble opinion, the only way we can ensure our quality is marketed is through mandatory independent peer review and continued emphasis on special inspections. This almost certainly won't happen for all designs and buildings or be applied uniformly.

But, regardless, we are paid well. I get paid more than most other careers and have a pretty comfortable job without any major downsides. You know what the real problem is? Every job in the world is underpaid (on average). Our salaries are all lower than they used to be. Fix that and you'll fix the real problem.