The Pay Gap in Medicine

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Let's dig in to understanding the gender pay gap, and its impact on women in medicine. Let's look at data on the pay gap across all fields of medicine and across specialties.

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Women working full-time in the United States make 82 cents for every dollar earned by men. (1) Period. Despite the fact that in 2019, women outpaced men in terms of college-educated members of the work force with 29.5 million women compared to 29.3 million men. (2) Despite the numbers becoming equal, the pay rate is NOT. A pay gap exists.

When we look at the field of medicine, we see similar trends. In 2017, women outnumbered men for medical school matriculants. However the gender pay gap continues in medicine, and at a steeper cost for women. According to a report by the American Association of University Women, female physicians are compensated only 71 cents for every dollar their male colleagues earn - a 29% gap.(3) When you look at aggregate data of “all” physicians, the gap will be more pronounced, as females more frequently choose lower paying specialties such as pediatrics (63.3% female) as opposed to higher paying specialties like orthopedic surgery (5.3% female) or neurosurgery (8.4% female).

Doximity has been publishing reports for the last four years on physician data. They survey their members and only include data from physicians working FULL-TIME (over 40 hours per week). The 2020 report collected self-reported data from 2019 and 2020 from over 44,000 physicians across the country in all specialties. They controlled for differences in specialty, geography, how long providers have been in practice and average hours worked per week using a multivariate regression analysis. There are certainly weaknesses in this data… it is self-reported being a big one. Women are well known for underselling their accomplishments. Men may tend to oversell their accomplishments. However this is the data we have, so let’s dive into it.

In general, subspecialties especially surgical subspecialties with longer training tend to have the best compensation. The 2020 Doximity report ranks the top 5 specialties for compensation as: Neurosurgery, Thoracic Surgery, Orthopedic Surgery, Plastic Surgery and Oral & Maxillofacial Surgery. If we look at the percentage of women in each of these specialties, it is as follows:

When we look at the specialties with the lowest compensation from the 2019 Doximity reports, we see the following: (*We are not referring to the 2020 Doximity report here because it is unclear if the grouped pediatric subspecialties with general pediatrics. Those were clearly separated in the 2019 report, potentially making that more credible data.)

Anyone else see an issue here????

Now if we compare male and female incomes WITHIN a specialty, we see a persistent gap. See the image below for the specialties with the largest and smallest wage gaps found in the 2020 report from Doximity.

So when we compare specialties instead of ALL physicians, we see a gap that exists from 2.5% to 22%, as opposed to the previously mentioned 29%. Much improved!!!

But let’s dig a little deeper.

Hematology has a gap of 11.4%. On average, men in hematology bring home $35,673 PER YEAR than their female colleagues in hematology.

Women in Emergency Medicine are making 12.6% less than their male colleagues. In dollars, that’s an average of $45,380 more annually that male EM physicians are making than their female colleagues.

If we look at orthopedic surgeons, the gap is 20% which translates to $122,677 difference between the average salaries of male and female orthopedists.

When we look past percentages to dollar signs, we see that women are taking home SIGNIFICANTLY less money than their male colleagues. Even when you look at the specialties with the SMALLEST gap, you see differences in pay of OVER 50,000 dollars per year. When you consider that over a 25 year career, that is $1,250,000. That is OVER ONE MILLION DOLLARS ladies! When we look at specialties with larger gaps, for example orthopedics, we see over 100,000 dollars per year. That is over $2,500,000 over a lifetime. Let me say that again OVER 2.5 MILLION DOLLARS. Are you cringing? I am!

As I said previously, the weakness of this data is that it is self-reported. We don’t know how many of each type of physician is reporting. When we compare year to year, the specialties with highest and lowest gaps change, making the data more questionable. It is unlikely that a specialty goes from 4% gap to 11.4% gap (as Hematology did from 2019 to 2020). It is more likely that the percentage is based on too small of a sample size and thus greatly affected by different reports. That being said, the TRENDS that we see are real and something we should be aware of.

So what can we do about it?

On a personal level, we all can ASK for more.

We can negotiate for each and every job offer.

We can get INFORMED about what other people are making so that we can negotiate BETTER to decrease the gap.

Also get informed about this fact: women EXPECT to earn less than men do. Study after study shows that women UNDERVALUE themselves. So take what you expect to earn and ADD MORE!

Consider taking a negotiation class or read a book on negotiation.

But this isn’t JUST a personal thing. We need institutional changes and national changes to improve these gaps.

We need pay transparency. This would allow women (and men) to know what other people working at that institution are making so that they can negotiate from a more informed place.

We need FAMILY leave policies to normalize women AND men to take leave for the birth of their child, an adoption or to care for elderly family members. By normalizing this for all, we will decrease the maternal discrimination that occurs as women start families. (Yup, studies have shown that women’s pay DECREASES with children while, you guessed it, men with kids see pay increases).

We need institutions to enforce pay audits, post salaries and eliminate the use of “pay history”.

We need to have conversations like this about the gender pay gap, share data, and encourage those around us to do the same.

So share this post on your social media.

Discuss it with your friends and colleagues.

Let’s increase awareness and transparency around the gap.

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