Do Women Doctors Need to Negotiate More Assertively?

Shelly Reese

Disclosures

August 05, 2015

In This Article

Introduction

It's no secret that female physicians earn less than their male counterparts, and that the problem has persisted for many years, despite the fact that women are entering medicine in greater and greater numbers.

Even after specialty and other workforce factors that have long been cited as reasons for the pay gap are controlled for, research shows that female doctors earn less than their male peers.

Although the factors contributing to the wage gap may be myriad and subtle, one possibility that has gained both traction and opposition is that female physicians simply may not negotiate as well as men.

Mind the Gap

Female physicians have heard the old saw a thousand times: They earn less than male doctors because they're more likely to go into primary care rather than the more lucrative subspecialties. According to the 2015 Medscape Physician Compensation Report, employed male physicians earn nearly 23% more than their female counterparts ($249,000 vs $203,000 annually). Fewer women also reported working in high-paying specialties, such as gastroenterology, cardiology, orthopedics, and urology.[1]

But as a study published in the February 2011 issue of Health Affairs[2] demonstrated, those factors don't fully explain the pay gap.

The study set out to explore the pay gap by making an apples-to-apples comparison of starting salaries among newly trained physicians in New York state over a 10-year period. After controlling for specialty type, hours worked, and other characteristics, researchers found not only that female physicians earned less, but the discrepancy was getting worse, growing from an average $3600 gap in 1999 to a $16,819 differential in 2008.

Anthony Lo Sasso, PhD, a professor of health policy and administration at the University of Illinois at Chicago and the lead author on the Health Affairs study, says one possible explanation is that female physicians may prefer compensation packages that emphasize nonmonetary benefits. If that's the case, he says, female physicians may be "voting with their feet" and choosing employers on the basis of family considerations or advancement potential, rather than those that offer richer compensation packages.

Hogwash, says Theresa Rohr-Kirchgraber, MD, president of the American Medical Women's Association (AMWA) and executive director of Indiana University's National Center of Excellence in Women's Health. Dr Rohr-Kirchgraber cites Lo Sasso's study as evidence the system discriminates against women and that female physicians—far from getting what they want out of the hiring process—are settling for lower wages in part because they lack the information or training to negotiate effectively.

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