A gender gap in starting salaries between newly trained male and female physicians has increased from a difference of $3,600 in 1999 to $16,819 in 2008. A new study published in the February issue of Health Affairs reports the gap exists after accounting for medical specialty, hours worked and practice type. At stake is the looming primary care shortage.
From 1999 to 2008 the pay gap widened between male and female physicians. In 1999, new women physicians earned $151,600 on average compared to $173,400 for men, or a 12.5% salary difference. That difference grew to nearly 17% by 2008, with women starting out at $174,000 compared to $209,300 for men.
The authors based their conclusions on survey data from physicians exiting training programs in New York State, which at 1,073 programs has more residency programs and resident physicians than any other state in the country. The survey sample included 4,918 men and 3,315 women.
By focusing on physicians at the very start of their clinical careers, researchers were able to eliminate potential differences in productivity as a confounding factor.
The authors contend that the differences in pay persist even when adjusting for differences in work hours, specialty choice, practice location, and numerous other factors. Potential reasons that cannot be ruled out include an increase in gender discrimination and that women are not as skilled as men at negotiating salaries.
But the authors also wrote that female physicians are seeking greater flexibility and family-friendly benefits, such as not being on call. They suggests that women may be negotiating these conditions of employment at the same time that they are negotiating their starting salaries.
Historically, women have disproportionately chosen primary care fields such as internal medicine, family practice or pediatrics. But the percentage of women entering primary care dropped from nearly 50% in 1999 to just over 30% in 2008. Despite entering higher-paying specialties, the widening gap in pay persisted. For example, the study found that:
--Female heart surgeons were paid $27,103 less on average than males;
--Female otolaryngologists made $32,207 less than males; and
--Female pulmonologists made $44,320 less than males.
In spite of the accelerating entry of female physicians into formerly male-dominated and traditionally higher paying subspecialties, there was a widening gap in physician compensation during the study period. Women make up nearly half of all U.S. medical students and are projected to make up about one-third of all practicing physicians in coming years.
"The need to retool the way in which female providers are recruited is likely to become more urgent as a consequence of the Affordable Care Act," the authors wrote. "In 2014 and beyond, the physician workforce will probably be strained by the demands of the anticipated 30 million or more newly insured Americans. The increased need for physicians, particularly in primary care fields, to treat the newly insured will place a brighter spotlight on physician compensation arrangements."