Compensation Issues

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Male Physicians Still Out-Earn Female Physicians in Almost Every Specialty

In 1980, female physicians comprised 11.6 percent of the physician workforce; by 2009, they had grown to 29.6 percent of the total physician population. According to a 2008 report titled "Gender Disparities in Physician Income and Advancement" by the American Medical Association, female physicians represented 45.3 percent of all residents and fellows in 2009, compared to 21.5 percent of all residents and fellows in 1980. The most popular female physician specialty, internal medicine, saw 54,085 total female physicians and 11,902 total female residents, representing 22 percent of the total amount.

But despite this growth in the number of female physicians, women have trailed men in advancement in the medical profession as well as salary and income levels. According to data published by the MGMA in 2010, men still outpaced women in almost every reported specialty (the exceptions being anatomic pathology and critical care pulmonary medicine). In some cases, the salary difference was minor: Male pediatricians specializing in gastroenterology earned, on average, less than $8,000 more than their female counterparts. In other cases, the discrepancy was substantial: Male gastroenterologists earned more than $120,000 more a year than female gastroenterologists.

A study published in Health Affairs in Feb. 2011 indicated that the gender gap in starting salaries for female physicians is widening, rising from a difference of $3,600 in 1999 to $16,819 in 2008. The Health Affairs report did not draw a conclusion about the reason for the widening pay gap, but acknowledged that potential reasons could include an increase in gender discrimination and the possibility that men are better at negotiating salaries than women.

In response to the study, Donald J. Harris, PhD, Research Director for Pennmetrics, wrote that, "It also may be worth considering that the missing variables play a much larger role in the high-stakes subspecialty fields. One might get a handle by examining, by way of separate regressions, the magnitude of the salary disparities in the four specialties with the largest Ns: pediatrics (general), internal medicine (general), family practice, emergency medicine." He also raised the possibility that "cultural" variables, such as the prestige of training institutions or employing institutions, might play a role in the discrepancy.

In its 2008 report, the American Medical Association also acknowledged that "gender disparities in medicine can be attributed to a certain degree to gender differences in specialty choice, age/experience, practice characteristics and life style choices." But in research published by J.E. McMurray and colleagues in the Journal of General Internal Medicine in 2000, the researchers found a $22,000 gender gap in income for women physicians after controlling for age and hours worked among pediatricians, family medicine physicians and internal medicine physicians. The income difference persisted among younger physicians, suggesting that the trend is not merely a holdover from a bygone era.

Evidence also shows that female physicians are paid less than male physicians even in those specialties where they come close to the majority. A report from the Center for Studying Health System Change, a nonpartisan policy research organization funded by the Robert Wood Johnson Foundation, stated in 2007 that women physicians account for 49.5 percent of the primary care workforce but earn 22 percent less than male primary care physicians. Again, this disparity may be attributed to a number of variables. In a 2006 AAMC/AMA Survey of Physicians Under 50, male physicians were found to be more concerned about career advancement, practice income and long-term earning potential. In contrast, female physicians were more interested in having the ability to balance time for family and personal life. AMA survey data have also consistently shown that female physicians work fewer hours and see fewer patients than male physicians.

Other factors affecting the pay gap include the difference in practice ownership: in 2003, 44.2 percent of female physicians were practice owners, in comparison to 66.2 percent of male physicians, according to Physician Income: The Decade in Review Physician Socioeconomic Statistics, a 2003 report by C.K. Kane and H. Loeblich. Additionally, based on 2006 AMA Physician Masterfile Data, 71 percent of male physicians were board-certified, compared to 65 percent of female physicians.

The AMA concluded in the 2008 report that steps are necessary to increase the ability of female physicians to advance in their careers, demand competitive salaries and negotiate strong contracts. "Transparency in pay scale and promotion criteria is also necessary to promote gender equity," the authors wrote. Compensation and promotion rates should be reviewed regularly by hospital and practice administrators to determine whether or not discriminatory trends exist. Hospitals and practices should also work to develop mentoring and role modeling programs for female physicians.

Read more on compensation:

-Anesthesia Highest Earner of All Hospital-Based Physician Specialties

-All New York State Salaries Now Listed Online

-Palomar Pomerado Hospital CEO Leads List of California's Top-Paid Special District Workers

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