The Gender Gap in Physician Salaries

The number of women entering U.S. medical schools in 2018 outnumbered the number of men for the second year in a row, according to the Association of American Medical Colleges. Yet, even with 51.6 percent of the incoming class, these future physicians will likely be paid less on average than their male counterparts for less, in some cases.

Recent salary surveys show resoundingly that a gender pay gap persists between men and women physicians, while some of the finer details between studies vary.

A new report from Doximity indicates some progress as women physicians’ salaries increased slightly last year while men physicians’ salaries remained stagnant.

“It was a little surprising, in a good way,” said Christopher Whaley, Ph.D., lead author of the Doximity study and adjunct assistant professor at the University of California, Berkeley School of Public Health. The data was released on March 26, 2019, in the medical network’s third annual Physician Compensation Report.

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“The gap is not narrowing fast enough,” said Theresa Rohr-Kirchgraber, MD, FACP, FAMWA, executive director of Indiana University’s Center of Excellence in Women’s Health in Indianapolis and past president of the American Medical Women’s Association. She added that women physicians often do not appreciate their own worth.

Heidi Moawad, MD, a neurologist and author of Careers Beyond Clinical Medicine, who has written about the gender earnings gap among physicians, said she found the Doximity results “definitely interesting.”

The Doximity study involved 90,000 physicians and found for every $1 female physicians earn, male physicians earn an average of $1.25.

“The trend is in the right direction, but in the grand scheme of things, there is still a large gap between male and female physicians,” Whaley said.

Variations in the gender pay gap 

The Doximity study found a wide variation in physician wages exists among different communities. Larger metropolitan areas in high demand tend to pay less compensation than areas less attractive to physicians. Areas with medical schools also pay less overall.

Cities with the smallest gender wage gaps for physicians in 2018 were Birmingham, Alabama, with a 9 percent earnings gap, a difference of $28,542; Bridgeport, Connecticut, at 10 percent; and Milwaukee at 14 percent.

Cities with the largest gender pay gap for physicians were Louisville/Jefferson County at 40 percent, a difference of $154,077; New Orleans at 32 percent; and Austin, Texas, Hartford, Connecticut, and Dallas at 31 percent.

Whaley controlled for specialty among those in the study while noting that women are more likely to go into primary care, which has lower compensation than other specialties. Men often are attracted to higher-paying specialties like neurosurgery and cardiology.

Additional wage studies 

While the Doximity report showed the gender pay gap decreasing slightly, the new Medscape Physician Compensation Report 2019, released April 10, found that the gap is getting wider compared to their previous reports. Medscape found that male primary care physicians earn nearly 25 percent more than women primary care doctors, $258,000 vs. $207,000 on average. This difference had increased from an 18 percent gap in 2018.

The wage gap was even larger among specialists, with men earning about 33 percent more than women specialists: $372,000 as compared to $280,000. This year’s Medscape report included responses from nearly 20,000 physicians in more than 30 specialties.

Regional studies can add to the overall picture. For instance, in a 2018 study by Merritt Hawkins of Maryland physician pay, researchers found male physicians earned almost 50 percent more than female physicians: an average of $335,000 compared to $224,000.

The salaries in academics also show a gender disparity, as demonstrated by a 2016 study published in JAMA Internal Medicine. Researchers found a nearly 39 percent unadjusted difference in the salaries of men and women physicians with faculty appointments at 24 public medical schools. 

About the physician salary gap

 At its 2018 annual meeting, the American Medical Association House of Delegates adopted new policies to support pay structures based on objective factors, not gender. President Barbara L. McAneny, MD, said in a release that the AMA will commit to paying equity in its office.

Toward that goal, here are some key recommendations for employers and physician candidates:

• Eliminate prior salary questions on physician job applications. Moawad agreed with this AMA recommendation, saying, “When an employer asks for previous income, that builds a legacy for people who were paid unfairly at one time.”
  
  
• Keep all interview questions work-related and gender-neutral. Employers tend to ask women but not men about childcare, working part-time or other assumptions, Moawad said. Rohr-Kirchgraber advised leaving all such social questions out of the discussion and recommends that women physicians turn any unfair questions back to the interviewer.
  
  
• Women should sharpen their negotiating skills. Moawad said that women tend not to negotiate for better salaries and benefits. Rohr-Kirchgraber teaches a “Negotiating the Divide” seminar for women physicians, and notes that other factors besides salary offer opportunities for higher overall compensation, such as sign-on bonuses and time off. [Note: Physician candidates can also negotiate terms for&nbsplocum tenens assignments.]
  
  
• Use data from other job offers. Women physicians often will not interview for positions they do not plan on accepting, Rohr-Kirchgraber said. Yet they could use those offers as a bargaining chip. “Women do not look for other job offers when negotiating for our current physician [salary],” she explained. “We tend to be nice and not aggressive.”
  
  
• Help to change perceptions. “Seventy-one percent of women physicians are the family breadwinner, but perceptions exist that women do not need money as much as men,” Rohr-Kirchgraber said.
  
  
• Speak up about inequity. Women physicians who feel they are not getting paid fairly often internalize it and will cut back on hours or leave the profession, Rohr-Kirchgraber added. And it is a great loss. “Every time we lose a physician from the workforce, we lose the potential to treat 400,000 patients,” she said.
  
  

Women physicians have better outcomes, Rohr-Kirchgraber said, but that does not equate with better pay.

“There are many different ways gender parity can be addressed,” she concluded. “We have to look at the small things as well as the big things.”

Related:
How to Negotiate a Physician Contract 
Work-Life Balance for Women in Medicine  

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