Female MDs Likely to Have Educated Spouses With Careers

Norra MacReady

November 22, 2017

Female physicians are more likely than their male counterparts to have a highly educated spouse who works outside the home, the authors of a new study write.

In an analysis of more than 42,000 couples in which at least one spouse was a physician, "46.0% of male physicians' spouses worked 0 paid hours outside the home compared with 8.8% of female physicians' spouses," they say in a research letter published November 20 in the Annals of Internal Medicine. "Overall, 52.2% of female physicians' spouses had a graduate degree compared with 39.9% of male physicians' spouses."

These findings may help explain why female physicians more readily adjust their work lives to accommodate family obligations and earn less than their male colleagues, lead author Dan P. Ly, MD, MPP, from Harvard Medical School, Boston, Massachusetts, and colleagues write.

They analyzed data from the American Community Survey, gathered between 2000 and 2015. The survey is administered by the US Census to approximately 3 million households and includes self-reported information on income, occupation, education level, and hours worked outside the home.

For this study, the authors compared data on married male and female physicians aged 25 to 50 years. They excluded same-sex couples, as the focus was on sex differences in the marriages.

The final sample consisted of 42,903 couples, including 30,898 male physicians and 17,625 female physicians and 5620 couples in which both spouses were physicians. Of the male physicians, 17.1% were married to a physician compared with 31.4% of the female physicians.

In dual-physician couples, the husbands reported a mean annual income of $219,047 (95% confidence interval [CI], $213,775 - $224,319) and spent a mean of 55.9 (95% CI, 55.4 - 56.6) hours per week working outside the home. The wives had a mean annual income of $131,845 (95% CI, $128,086 - $135,604) and worked outside the home for a mean of 44.5 (95% CI, 43.8 - 45.2) hours per week.

In couples consisting of a male physician and female nonphysician, the mean annual income for physicians was $234,736 (95% CI, $231,973 - $237,498; P < .001 compared with men in dual-physician couples), and they worked outside the home for a mean of 56.1 (95% CI, 55.8 - 56.4) hours per week. The female members of these couples had a mean annual income of $27,218 (95% CI, $26,380 - $28,056) and spent a mean of 17.3 (95% CI, 17.0 - 17.7) hours per week working outside the home.

However, male nonphysicians married to female physicians had a mean annual income of $97,761 (95% CI, $95,300 - $100,223; P < .001 compared with female nonphysicians) and worked outside the home for a mean of 41.1 (95% CI, 40.7 - 41.5; P < .001 compared with female nonphysicians) hours per week, whereas their wives reported a mean income of $143,155 (95% CI, $140,391 - $145,918) and spent a mean of 47.5 (95% CI, 47.1 - 48.0) hours per week working outside the home (P < .001 compared with women in dual-physician couples for income and hours worked).

Of male nonphysicians married to physicians, 52.2% (95% CI, 50.9% - 53.4%) had a graduate degree compared with 39.9% of women nonphysicians married to physicians (95% CI, 39.1% - 40.7%; P < .001).

Couples in which only the husband was a physician also had more children: a mean of 1.86 (95% CI, 1.84 - 1.88) compared with a mean of 1.57 (95% CI, 1.53 -1 .61) for dual-physician couples and 1.40 (95% CI, 1.38 - 1.43) for couples in which only the wife was a physician. These differences were statistically significant (P < .001) in comparisons of male with female nonphysicians, male physicians in dual-physician vs single-physician couples, and female physicians in dual-physician vs single-physician couples.

Overall, the findings suggest that having an educated spouse with a career outside the home "may affect decisions on intrahousehold time allocation, placing greater pressure on female physicians to trade professional for household responsibilities," the authors write.

Indeed, they conclude, the findings "may not be specific to physicians and may reflect traditional gender roles more broadly."

Dr Ly has disclosed no relevant financial relationships. The other study authors reported receiving grants from the National Institutes of Health during the conduct of the study; personal fees from Pfizer, Hill Rom Services Inc, Bristol Myers Squibb, Novartis Pharmaceuticals, Vertex Pharmaceuticals, and Precision Health Economics outside the submitted work; and support from an unrestricted departmental grant to the University of Southern California Department of Ophthalmology from Research to Prevent Blindness, as well as consulting income unrelated to this study from Precision Health Economics, LLC, a consulting firm for the life sciences industry.

Ann Intern Med. Published online November 20, 2017. Abstract

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