Female Doctors' Pay Still Falls Short -- Why?

Anne L. Finger, MA

Disclosures

May 15, 2015

In This Article

More Women Choose Quality of Life

As in the past, women are more likely to enter the lower-paying specialties; they now represent more than half of all pediatricians and ob/gyns. At the same time, they're considerably less likely to choose surgical specialties, which pay a lot better. Specifically, Medscape found that primary care physicians averaged $195,000 a year while specialists made $284,000—and the highest-earning specialists were orthopedists ($421,000) and cardiologists ($376,000).

Farzanna S. Haffizulla, MD, a Florida internist and president of the American Medical Women's Association (AMWA), is a case in point. "I went to medical school expecting to become a cardiothoracic surgeon," she says. "But I met my husband, married, and became pregnant in my second year."

Dr Haffizulla wanted a work-life balance that she felt precluded surgery. But "in my third year," she says, "I realized it wasn't just work-life balance: I enjoyed all the specialties, so I followed my passions and priorities to internal medicine."

Why do so many women choose similar specialties? "I think that many women have a looming fear that they may bypass their childbearing years," she says. But, she recalls, another subset of women in her class tried to get into the higher-income, male-dominated specialties and didn't get a match. Why not? "That's an unanswered question," she says.

Another factor affecting compensation is the amount of time worked, and women tend to put in fewer hours per week and see fewer patients than do men.[3,4] The Medscape survey found that female physicians were nearly twice as likely to work part-time: 24% of women vs 13% of men. However, Hal C. Lawrence III, MD, who is executive vice president and CEO of the American Congress of Obstetricians and Gynecologists (ACOG), says that, increasingly, among young, married physician couples, neither spouse works 5 days a week, "so that one parent is always available for their children."

Self-employment Helps Close the Pay Gap

According to our survey, physicians who are self-employed earn more than those who receive a salary. Although 63% of doctors reported that they're now employed compared with 32% who are in private practice, there's a gender difference here, too: More than a third of men (36%) are self-employed, compared with roughly a quarter of women (23%), which represents a slight uptick (1%) from the 22% of women who reported self-employment in Medscape's 2014 survey.

Here's the kicker, though: This year's survey report found little difference in the extent to which self-employment was an income advantage to men as compared with women.

All told, can we therefore conclude that the compensation discrepancies between male and female physicians are largely due to specific decisions that women make—choosing lower-paying specialties, working fewer hours, and accepting salaried positions? Possibly, but it may not be the full picture. Here's some of what we do know:

  • A Health Affairs article published in 2011[5] found nearly a $17,000 male/female pay gap for newly trained physicians in New York State that couldn't be explained by choice of specialty, hours worked, type of practice, or other factors, and the gap seemed to have widened, from a $3600 disparity in 1999. During this period, a growing number of women entered the higher-paying specialties, but the income differences continued—in both primary care and non-primary care.

  • A JAMA article published in 2012[6] studied academic physicians mid-career and found that the salaries for men were $13,399 higher than those for women, even after adjustments were made for academic rank, specialties, leadership positions, research time, and publications. (The preadjusted salary figures were $200,433 vs $167,669, in favor of men.) To ensure that the sample was homogeneous, the authors' sample group was physicians who had received National Institutes of Health career development awards in the years 2000-2003 and who remained in academic institutions.

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