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Gender Gap Widens in Physicians' Starting Salaries

 |  By John Commins  
   February 03, 2011

Starting salaries for female physicians are much less than those of their male counterparts, and the gender gap is widening by the year, regardless of the medical specialty, a study in Health Affairs finds.

The disparity in starting salaries has been growing steadily since 1999, increasing from a difference of $3,600 in 1999 to $16,819 in 2008. This gap exists even after accounting for gender differences in determinants of salary including medical specialty, hours worked, and practice type, the study found.

The authors based their conclusions on survey data from physicians exiting training programs in New York State, which has more residency programs and resident physicians than any other state. The physician survey sample included 4,918 men and 3,315 women.

In 1999, new women physicians earned $151,600 on average compared to $173,400 for men—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 study found.

Women had lower starting salaries than men in nearly all specialties, said study lead author Anthony Lo Sasso, a professor and senior research scientist at the School of Public Health of the University of Illinois at Chicago.

“It is not surprising to say that women physicians make less than male physicians because women traditionally choose lower-paying jobs in primary care fields or they choose to work fewer hours,” Lo Sasso said.  “What is surprising is that even when we account for specialty and hours and other factors, we see this growing unexplained gap in starting salary. The same gap exists for women in primary care as it does in specialty fields.”

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, the study said.

Lo Sasso said the divergence may reflect the fact that women physicians want greater flexibility and family-friendly benefits, such as not being on call after certain hours. He said women may be negotiating these conditions at the same time that they are negotiating starting salaries. “It may be that lifestyle factors are increasingly important to newer physicians. It could be that women in particular want to have more of a lifestyle balance in their medical careers,” he said.

Women represent nearly half of all medical students and are projected to make up about one-third of all practicing physicians at the beginning of this coming decade. Historically, women have disproportionately chosen primary care fields. 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. Women specializing in pulmonary disease made $44,320 less than men.

Lo Sasso said physicians and specialty groups need to understand what is motivating the gender gap in physician pay and address it, especially given the increased need for physicians, particularly in the primary care field. He said policy makers and physician practices should reconsider how to attract providers, the structure of working arrangements, and how to pay providers.  

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.

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