The wage gap for female physicians

There has been much attention this weekend to a comment made by a internal medicine physician from Plano, TX in the Dallas Medical Journal regarding the gender pay gap.  For anyone who missed it, Dr Tigges claimed that “Female physicians do not work as hard…they don’t want to work the long hours. Nothing needs to be “done” about this unless female physicians actually want to work harder and put in the hours.”  He was brought to spotlight shame by social media, and left a stream of negative reviews on every platform possible.

In addition to the ridiculous comment above, the there were many other troubling posts that the gender pay gap does not exist.  First, let me clarify that the gender pay gap for physicians is a problem.  While the above post caused outrage, the real danger is in apathy.  People can easily say discrimination is wrong, people should be treated equally, etc, but recognizing when discrimination happens is more difficult.  Remember, privilege is often invisible to those who have it.  As the chair of DMJ Communications Committee stated, “This is not a new concept.  There are many more physicians that do not see the discrimination, the misguided prejudices that influence our employment.  The danger is in the physicians that think this, but do not express it, or justify it.  Many of these people are in power and influence when women are offered less than their male counterparts.”

1. The pay gap for female physicians not only exists, it is growing wider.

According to a survey of 65,000 physicians by Doximity (a social networking platform for health care professionals) women doctors earned an average of 27.7% less than their male counterparts in 2017.  The pay gap had widened from the prior year, when Doximity found women physicians were making an average of 26.5% less than men. And the researchers reported that the inequities persisted across all 40 medical specialties and 50 metropolitan areas that it analyzed.

2.  Women (overall) are more likely to work part time or choose a lower paying specialty

Women are more likely to enter lower paying specialities such as family medicine, pediatrics and Ob/Gyn.  Women are also more likely to work part time.  Although it is 2018, in most households women are still responsible for the majority of child rearing and housework.  This certainly does not apply to all women, but statistics do support support this as an overall trend.

3.  The pay gap remains even after controlling for all other factors.

A study from Duke University and the University of Michigan, as well as one in JAMA Internal Medicine, and the BMJ confirmed that women the gap remained even after taking into account hours worked, specialty, publications, age, experience, promotions, research activity and clinical revenue.  Women are paid less for the same work.  This is not because they work less.  This is because of discrimination.  A major report by the United States Academy of Science  that have shown that both men and women tend to underestimate women’s work and abilities.

4.  Although more women than men are entering medical school, women are still underrepresented in leadership

Women account for 16% of deans of American medical schools.  Only 15.7% of Department Chairs are women, according to 2015 AAMC data.

5.  If women were paid by outcome, the wage gap might flip the other way.

A study of medicare patients showed that elderly hospitalized patients treated by female internists have lower mortality and readmissions compared with those cared for by male internists.  In another study, women surgeons had lower 30 days mortality and readmission rates.  An additional study showed patients of female PCPs are more likely to get cancer screenings, diabetes management and referral to specialists.  They also have fewer emergency room visits and hospital admissions.  See this link below for all the data.

Patients often fare better under the care of female doctors

This discussion is what we need!  In many cases this gender bias may be unintentional, and unrecognized.  Bringing it to light is the first step in creating a solution.  To begin to solve this, we need transparency and standardization, so we can have accountability.   Leaders need to be aware of the bias and takes steps to address this.  Women need to negotiate aggressively for salary and raises.   I am optimistic that all the attention given this issue will continue to lead to awareness, discussion and solutions in the future.