Doctors & Diversity: Gender Pay Gap for Women

Gender Pay Gap
DOES GENDER PAY GAP START IN MED SCHOOLS? Studies say some women in med schools are encouraged to enter lower-paying specialties. Photo: B. Globa/Wikimedia Commons

The gender pay gap in America also applies to medicine, and the numbers are shocking. Female doctors are paid approximately 8% less per year than men, as much as nearly $20,000 less, a 2016 study published in JAMA Internal Medicine said. A New York Times article said the total difference in pay between male and female physicians can be as much as $51,000.

The gender pay gap is puzzling in 2017, particularly in medicine because the health care industry is one of the most diverse, and female doctors are some of America’s best and brightest.

In the latest installment of our Doctors and Diversity series, the UMHS Endeavour looks at the gender pay gap from various online sources, from Slate to the New York Times, KevinMD and others. We will give statistics from JAMA Internal Medicine, theories on why there is a pay gap, possible solutions to the problem, and tips from a female doctor about how women in medicine can get the highest pay they deserve.

JAMA Internal Medicine Study

A study published last summer in JAMA Internal Medicine by Harvard Medical School and Massachusetts General Hospital researchers looked at the salaries of 10,241 academic physicians and 24 U.S. medical schools. A post on Slate called “The Gender Pay Gap for Doctors is Atrocious” noted the average pay gap was between men and women “was $19,878 per year.”

A July 11, 2016 New York Times article “Dr. Paid Less: An Old Title Still Fits Female Physicians,” gave many alarming details about the issue.

“Before adjusting for factors that could influence income, the researchers found that the absolute difference between the genders was more than $51,000 a year,” Catherine Saint Louis wrote in the New York Times.

Some of the pay discrepancies, based on research quoted in the New York Times, included a gap between female and male orthopedic surgeons of “nearly $41,000” and “about $38,000 among oncologists and blood specialists, about $36,000 among obstetrician-gynecologists and $38,000 among cardiologists.”

Radiology is the sole specialty in which women earned more. The New York Times said female radiologists earn “roughly $2,000” more than men.

 

Gender Pay Gap
GENDER PAY GAP IN MEDICINE: With the exception of radiology, female doctors are paid less than men in nearly every specialty. Photo: National Cancer Institute/Wikimedia Commons

 

A Female Doctor’s Ideas for Correcting the Problem

Vineet M. Arora, MD wrote a provocative op-ed in Jama Internal Medicine back in September 2016 titled “It Is Time for Equal Pay for Equal Work for Physicians—Paging Dr. Ledbetter”. Dr. Ahora outlined the problems concerning the gender pay gap and what can be done to correct them. She cited a study showing “newly trained male physicians in New York State in 2008 made, on average, $16,819 more than newly trained female physicians, compared with a $3,600 difference 10 years earlier.”

In discussing the nearly $20,000 discrepancy between male and female doctors, Dr. Ahora talked about the “significant variation by site and specialty.”

“In two academic centers, there were no differences in physician income by sex,” she wrote. “Likewise, women in radiology did not experience a pay gap.”

With the exception of radiology, why is there such a huge pay gap among female doctors and their male counterparts? This is a complex issue indeed, with no simple answer. Dr. Arora refers to “a bevy of literature from other industries” suggesting “women are not as effective at negotiating salaries, highlighting the importance of building this skill for academic women in this area.”

The gender pay gap may go much deeper than negotiating skills, Dr. Arora said.

“Regardless of a woman’s ability or desire to negotiate, there could be a bias against women, such that supervisors do not offer as much when hiring because they know women will be less likely to negotiate. In this case, employer training and policies that promote salary transparency would be helpful,” Dr. Anora wrote.

She also said many believe men “are more aggressive than women in seeking offers and counteroffers that result in higher salaries,” and women are often married to other professionals and less likely to “assume the leading role in relocating the family, which is a necessary prerequisite to obtaining a lucrative offer or counteroffer.”

Dr. Anora’s suggestions for combatting the problem include a “loyalty bonus…for men and women with high performance who are not threatening to leave” a hospital or practice.

Reasons for the Gender Pay Gap

Several articles and studies discuss various reasons for the gender pay gap in medicine. A post on HealthcareDive.com “Is the Gender Wage Gap in Healthcare Getting Worse?” explores what the data says about the discrepancy in pay.

The article talks about two reasons given, and they may sound sexist to some: “In health care, studies have suggested that gender differences in physicians’ salaries can be accounted for by women’s tendency to enter the lower-paying Primary Care field and work fewer hours.”

While doing online research for this post, the UMHS Endeavour was surprised at the number of articles discussing how female doctors “work fewer hours” and choose specialties that pay less.

“A comprehensive 2011 study published in Health Affairs did find that a great percentage of newly-trained female physicians (38.1% compared to 24.5% of men) planned to spend fewer than 40 hours a week on patient care,” Katie Bo Williams wrote in the HealthcareDive.com post. “And a smaller percentage of new female docs (23.4% compared to 37.3% of men) plan to spend more than 50 hours a week on patient care.”

Regarding specialty choice, Ms. Williams cited a 1990-2003 study in which “the absolute number of female primary care physicians is rising (although the proportion of female docs who choose to enter the Primary Care field is decreasing). 13.9% of women are in Pediatrics, vs. 5% of men. Conversely, there is a smaller proportion of women in the higher-paying specialties (1.3% v. 4.1% in Cardiology, 1.8% v. 3.4% in Diagnostic Radiology).”

Is there a reason why so many women are going into Primary Care as opposed to more lucrative specialties? As Ms. Williams wrote, the argument that women simply choose lower-paying specialties is flawed because “it doesn’t look at why women are choosing lower-paying specialties. Does it express a preference, or are women choosing the specialties that are open to them?”

She also discusses the idea of female physicians leaving the workforce temporarily to get married and have children and “they return with less experience than their male counterparts, so—the argument goes—they get paid less.”

 

Gender pay gap
WOMEN IN PEDIATRICS: A study concluded in 2003 said 13.9% of women are in Pediatrics, vs. 5% of men. Pictured: A pediatrician examines a child circa 1974. Photo: Wikimedia Commons

A Female Physician’s Tips for Getting Equal Pay

The late Linda Brodsky, MD, a pediatric surgeon, wrote a proactive piece back in 2013 for KevinMD.com titled “6 Ways to Close the Gender Pay Gap in Medicine” shortly before her death in February 2014. Dr. Brodsky was an advocate of female doctors getting equal pay.

Highlights of the post, which advised women doctors to do their homework before tackling salary issues, include her advice to negotiate with the idea that “whatever you are offered, it is probably 40% less than what you would be offered if you were a man.”

Dr. Brodsky also noted the following:

  • “Know what you are worth.” She said “other physicians are the best source, so don’t be shy about asking. It’s time we talked to each other.”
  • Academic salaries can be found on the American Association of Medical Colleges (Note: Membership is required for access.)
  • Other resources include the Medical Group Management Association with information about group practice arrangements for a fee. Also visit Physician’s Practice which Dr. Brodsky said “can clue you in on your own worth as a physician in your own practice—membership required.”
  • Take note of the current doctor shortage. She said a doctor’s services are more valuable because there are fewer people providing them nowadays. Visit such websites as https://www.healthecareers.com/ and “be prepared to walk away from a place that undervalues you. And make sure you tell them why. Nicely.”
  • She said to be aware of which specialties pay the most and which pay the least. Dr. Brodsky talked about “horizontal segregation where women are openly encouraged in medical schools to populate…lower-paying specialties, thus further keeping the compensation rates down.” This doesn’t mean you should only aim for higher-paying specialties in medicine, but “be mindful of the value placed before you go in.”
  • Geography is important when considering job opportunities for women in medicine. As Dr. Brodsky said, “If you have flexibility, think about places that really need doctors. Central U.S. needs you badly. The Northeast, not so much. This is going to vary by specialty.”
  • Finally, Dr. Brodsky said to never underestimate “flexibility, predictability and control.” She said female doctors are often paid less because they trade higher salaries for these three areas. “No big secret, men want the same things and don’t give away their money to get them,” she wrote. “All three can be sold as ‘assets’ rather than ‘deficits’. Don’t trade away more than you need to.”

 


About UMHS:

Built in the tradition of the best U.S. universities, the University of Medicine and Health Sciences focuses on individualized student attention, small class sizes and recruiting high-quality faculty. For these reasons, UMHS is quickly becoming the school of choice among Caribbean medical schools.

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