Gender Gaps In Physician Pay: Why?
Image attribution: Dallas Medical Journal and The NYTimes
If you haven’t yet seen this quote from a physician that was recently (yes, not from 1950) published in a state medical journal, you probably will soon. It’s blowing up on social media.
“Yes, there is a pay gap. Female physicians do not work as hard and do not see as many patients as male physicians. This is because they choose to, or simply don’t want to be rushed, or they don’t want to work long hours. Most of the time, their priority is something else… family, social, whatever. Nothing needs to be “done” about this unless female physicians actually want to work harder and put in the hours. If not, they should be paid less. That is fair.”
I’m not going to focus on who supplied this quote. Truthfully, it doesn’t matter. This attitude/belief is out there, and it’s not limited to one physician, or even to medicine as a profession. I could tell you literally hundreds of anecdotes which counter this statement based on physicians I’ve talked to at this point, but I am going to contain myself, and just debunk this statement with facts.
I’ll start by acknowledging two truths. Women physicians are more likely to work part time, and do, on average, work fewer hours than male physicians (on average — ask me to show you a female physician who puts over 80 hours a week, and I could rattle off quite a few). The reasons for this are manyfold, including physician family demographics and traditional gender roles, which I'll avoid launching into on this post, but certainly play a factor. Here are 2 images from the recent 2018 Medscape Female Physician Compensation Report:
Another reason not mentioned by the quote, but often cited for the gender pay gap between physicians, is a difference in the number of years of experience by female physicians, as there are certainly a higher percentage of females coming into the field, and therefore on average, the average male physician has been practicing longer than the average female physician.
HOWEVER: in large scale studies which have actually controlled for years of experience, productivity, and hours worked, there is still a very significant pay gap. One such study worth looking into is this article in the BMJ from 2016, which shows that even when accounting for these factors, there is a $18-19k pay gap. As this study from JAMA internal medicine shows, even when accounting for age, experience, number of publications, Medicare reimbursements, and other factors, there is a large difference in pay in many specialties at academic medical centers.
These numbers may be much greater in other practice settings.
Think that doesn’t matter? A $20,000 dollar difference in salary per year translates to a difference of between 1.5-2 million dollars over the course of a physician’s career, when accounting for growth of a portfolio/compound interest yielding 6% returns, and assuming an average career of 3 decades. More about that here.
I don’t like making the comparison between women and male physicians in terms of dedication to their jobs and their patients, because as we know, we can all identify excellent examples of physicians in both genders who practice medicine passionately and go above and beyond to care for their patients. I will say this though. Demographically, women physicians on average (again, on average) are less likely to be their family’s sole source of income, and are more likely to be married to high income partners than male physicians. Despite the fact that their families don’t rely on their income, they choose to manage the balancing act that is being a female physician, mother, etc, despite the challenges of today's healthcare environment. I would argue that willingly doing that demonstrates that their priority is, in fact, their passion for their careers and their patients.
I could go on forever about this topic (and often do), but suffice it to say, women physicians make their careers a priority, and there is a real physician gender pay gap that is not explained by women working less hours, billing less, or being less experienced. It’s a problem that people think these things, and it’s a problem that needs to be addressed by paying women physicians equal pay for equal work. Period.