By Debra Wood, RN, contributor Apr 15, 2019
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—far less, in some cases.
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.”
Recent salary surveys show resoundingly that a gender pay
gap persists between men and women physicians, while some of the finer details between
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, PhD, lead author of the Doximity
study and adjunct assistant professor at the University of
California, Berkeley School of Public Health. The data was released 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 women 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,”
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
Whaley controlled for specialty among those in 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.
What to do about the physician
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 pay equity in its office.
that goal, here are some key recommendations for employers and physician candidates:
Keep all interview questions work-related
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 locum tenens
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
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.”
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