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Physician Pay Disparities Persist Along Gender, Race Lines

News  |  By Alexandra Wilson Pecci  
   June 09, 2016

White male physicians had an adjusted median annual income of $253,042, compared with $188,230 for black male physicians between 2010 and 2013.

It pays to be a white male physician. Literally.

White male physicians in the United States earn substantially more than black male physicians, even after accounting for factors such as medical specialty, experience, and hours worked, a study published in the BMJ finds.

At the bottom of the income barrel are female physicians.

The study results also show that, although the incomes of black and white female physicians are similar to each other, they are significantly lower than their male counterparts.

"A lot of studies have looked at this issues," says lead author Anupam Jena, MD, PhD, Ruth L. Newhouse Associate Professor at Harvard Medical School. But they've been limited in size and data richness.

Race and Physician Pay

And, although many studies have looked at gender differences in physician pay, there has been little data about how black and white physician pay differed, Jena adds.

For the BMJ study, Jena and his fellow researchers used recent data from two nationally representative surveys: the 2000 to 2013 American Community Survey and the 2000 to 2008 Center for Studying Health System Change physician survey.

They adjusted ACS data for age, hours worked, time period, and state of residence, and HSC data for age, specialty, hours worked, time period, years in practice, practice type, and percentage of revenue from Medicare/Medicaid.

The income differences were significant.

For instance, the researchers found that between 2010 and 2013 in the ACS, white male physicians had an adjusted median annual income of $253,042, compared with $188,230 for black male physicians.

During the same period, white female physicians had an adjusted median annual income of $163,234, and black female physician earned $152,784.

Familiar Disparity

"It's actually very similar to what you see in the overall economy," Jena says of the black-white and male-female income disparity.

Yet he and his colleagues thought that they wouldn't find such stark differences, since physicians comprise a relatively homogenous group of highly educated people.

In addition, healthcare prices are fairly predictable, thanks to fixed fees from private insurers and the federal government.

"You'd expect that race-based difference to shrink away," he says.

The next question for researchers to dig into is whether disparities in job opportunities are a factor in the differences in earnings.

Jena says that "the constant criticism you see of studies like this" are whether or not the research accounted for differences in the physicians themselves, whether some see more Medicaid patients than others, and whether female physicians work fewer hours.

"The fact that you're having to control for these things is actually really relevant," he says. If research were to hypothetically show that black males are less likely to work in certain high-paying specialties, "it could very well be that black males have less access," he says.

"That's the subtle, but important point in this kind of research," he adds.  

Hospital executives should care about paying physicians equally, Jena says, not only because it's the right thing to do, but because it's a way to attract and retain top-tier talent.

"That's the private incentive," he says. "When you pay people differently for the same kind of work, you create incentives that may lead to you to be unable to attract the kind of talent that you want to attract."

Alexandra Wilson Pecci is an editor for HealthLeaders.


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