This is just a guess mind you but perhaps something like this would work:

SELECT DoctorID, LastName, FirstName

FROM (

UPDATE Doctors

SET NumImpressionsInSearches = NumImpressionsInSearches + 1

OUTPUT INSERTED.*

FROM Doctors

WHERE DoctorID IN (

SELECT DoctorID

FROM

(

SELECT

TotalRows = COUNT(*) OVER(),

RowNum =

CASE

WHEN @sortColumn = 'OccupationName_ASC' THEN ROW_NUMBER()OVER (ORDER BY O.OccupationName)

WHEN @sortColumn = 'City_ASC' THEN ROW_NUMBER()OVER (ORDER BY D.City)

WHEN @sortColumn = 'OccupationName_DESC' THEN ROW_NUMBER()OVER (ORDER BY O.OccupationName DESC)

WHEN @sortColumn = 'City_DESC' THEN ROW_NUMBER()OVER (ORDER BY D.City DESC)

ELSE ROW_NUMBER()OVER (ORDER BY NewID()) -- note this returns random order, and each page's results may not be unique.

END,

D.DoctorID, D.OccupationID, D.LastName, D.FirstName, D.Designations, D.NumRecommendations, D.City, D.State, D.Zip, D.Phone, D.NumProfileViews, D.ApprovedStatus, O.OccupationName, D.MembershipStatusID

FROM dbo.Doctors P WITH (NOLOCK)

INNER JOIN dbo.Occupations O ON O.OccupationID = D.OccupationID

INNER JOIN dbo.DoctorsPracticeAreas DPA ON DPA.DoctorID = D.DoctorID

WHERE DPA.PracticeAreaID = @practiceAreaID

AND (@occupationID IS NULL OR D.OccupationID = @occupationID)

AND (@name IS NULL OR D.LastName LIKE @name + '%' OR D.PracticeName LIKE '%' + @name + '%')

)

AS XYZ -- you need this AS XYZ

WHERE RowNum BETWEEN @startRow AND (@startRow + @rowsPerPage) - 1

)

) a