Medical practices with fewer women have bigger wage gaps

2020 07 29 20 51 6576 Doctor Workstation Woman2 400

Specialty medical practices that are dominated by men tend to have wider salary gaps between genders compared with practices with more female doctors, according to a study published July 30 in BMJ. The gap is smaller between genders in nonsurgical specialties like radiology.

The findings shed new light on the gender gap in salaries between male and female physicians and indicate that adding gender diversity to medical practices could be a way to help mitigate wage disparity, according to a team led by Dr. Anupam Jena, PhD, of the Blavatnik Institute at Harvard Medical School in Boston.

"There are many good reasons to have greater diversity in our workplaces, including the idea that if you make a workplace more diverse, some of the pay inequities we see will go away," he said. "This is exciting evidence that diversity can improve equity, not just in terms of representation, but in very tangible economic terms."

Data from the U.S. Census Bureau indicate that overall, women tend to make 18.9% less than men; said another way, women earn 81¢ for every dollar earned by men. This gap also exists in medicine -- for example, AuntMinnie.com's 2013 SalaryScan survey found that male radiologists made 20.1% more than female radiologists.

In the current study, Jena and colleagues sought to explore the relationship between gender mix and pay gaps among primary care and specialty physicians in the U.S. The Harvard team collaborated with researchers from the Rand Corporation, the University of California, Berkeley, and Doximity.

They based their research on data from a national survey of physician salaries from 2014 to 2018 that included more than 18,000 physicians from more than 9,000 group practices. They compared earnings across these practices by gender and fine-tuned the data for factors such as physician specialty, experience, hours worked, clinical workload, practice type, and geography.

Physicians were categorized into three groups: primary care, surgical specialists, and nonsurgical specialists, with radiologists falling into the last group. Mean annual income was $376,223 among primary care physicians, $374,774 among nonsurgical specialists, and $516,608 among surgical specialists.

Jena's group found that in nonsurgical specialty practices with at least as many women as men, men earned 12% more than women, but that gap increased to 20% in practices made up of more than 90% male physicians. This trend also manifests among the surgical specialists. Incomes did not appear to be affected by gender among primary care providers, the researchers noted.

Pay differences by medical practice gender mix and type of specialist in U.S.
Type of specialist Mean annual income ‑‑ all genders Pay gap at practices with less than 50% of male physicians Pay gap at practices with at least 90% of male physicians Relative pay difference between genders
Nonsurgical specialists (including radiology) $374,774 $36,604 $91,669 19.9%
Surgical specialists $516,608 $46,503 $149,460 26.9%

The study suggests that an equal gender mix in medical practice translates to more pay equity, senior author Christopher Whaley of the Rand Corporation said in the Harvard statement.

"Our findings suggest that increasing the gender diversity of specialty practices would do a lot to close the pay gap between men and women in medicine," he said. "[It's] yet another reason to push for greater diversity."

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