According to a major new study, female doctors earn less than their male colleagues from their first days on the job. Over the course of a 40-year career, researchers estimate, this pay gap adds up to at least $2 million.
The survey of more than 80,000 physicians, published Monday in the medical journal Health Affairs, is the largest analysis to date on physician salaries and the first to estimate the cumulative impact of pay gaps in medicine.
“We could see that essentially from year 1 to year 40 there’s a pretty big gap,” said Christopher Whaley, the study’s lead author and a health economist at the RAND Corporation, a non-partisan think tank.
The team of dr. Whaley used research data collected between 2014 and 2019. The pay gap has likely widened since then, he said, as the pandemic has forced women in many fields, including medicine, from the workplace to take on childcare and other household duties. responsibilities, reducing their cumulative career earnings.
“This will likely accelerate physician burnout,” said Dr. Whaley. “And that will only further exacerbate these wage issues.”
The researchers analyzed self-reported salary data submitted to Doximity, a social network similar to LinkedIn that claims to reach 80 percent of physicians in the United States. By comparing wages between men and women with the same amount of experience, the researchers estimated that male physicians earned an average of $8.3 million over a simulated 40-year career, while women earned about $6.3 million — a difference of nearly 25 per cent.
In their calculations, the researchers controlled for a range of factors that strongly influence pay, such as a physician’s specialty, type of practice and patient volume.
For example, more men are becoming surgeons – the highest paid of all physician specialties – while more women are going into primary care. And women have been shown to spend more time with their patients, leading to a lower number of services and procedures to be charged for.
Some of these measures are “themselves the likely manifestations of systemic bias or discrimination,” said Dr. Reshma Jagsi, a radiation oncologist and bioethicist at the University of Michigan medical school who was not involved with the new report. For example, studies have shown a widespread bias against women who apply for jobs in medicine that are traditionally or predominately held by men. And women in academic medicine are less likely to receive major research grants or hold leadership positions.
If the researchers hadn’t controlled for these variables, the estimated pay gap would have been much larger, they said. “Our numbers would roughly double,” said Dr. Whaley.
Even within specialties, the calculated pay gaps were significant: highest among surgeons, at around $2.5 million, and lowest among general practitioners, at nearly $920,000.
Although disparities in all sectors have narrowed in recent decades, almost all professions still pay women less. And the gap is wider among health care providers than among people with computer and technical jobs, for example.
The new study did not include data on people identifying as non-binary or transgender, and did not specify the race of the respondents, which previous research has shown is also a large factor influencing physician pay.
Salary information by race “is not systematically recorded anywhere,” said Dr. Whaley. “And I think that’s an important data limitation.”
The pay gaps started at the beginning of a doctor’s career and continued to widen until about 10 years without recovering, the study found. The gap remained stable for the rest of their careers, with women never catching up with the men.
This finding is “worrying, but not surprising,” said Dr. Snigdha Jain, a pulmonary and critical care physician at Yale School of Medicine who was not involved in the study. “Women physicians, who are in the prime of their reproductive years when they begin practice, experience insufficient maternity leave, inadequate guidance on return to work, and a disproportionate burden on childcare in subsequent years.”
While about the same number of women graduate from medical school as men, women make up only 36 percent of working doctors. Because the new study didn’t track individuals over time, it couldn’t capture the effects of this “leaky pipeline” on women’s cumulative income, said Dr. jain.
The findings suggest that the pay gap could be narrowed with policy changes affecting younger physicians, said Dr. Whaley. Offering more paid time off and more flexible scheduling, he said, or making salaries more transparent could help women earn their fair share.