Male primary care physicians earn 17% percent more than females, while males in specialty care are paid 37% more than females in the same field, an MGMA survey finds.
Age, gender, specialty and productivity are key factors in physician pay, survey data shows.
The Medical Group Management Association's 2017 Physician Compensation and Production Survey, released this week, uses comparative data of more than 120,000 providers across more than 6,600 groups and represents several practice models, including physician-owned, hospital-owned, academic practices, as well as providers from across the nation at small and large practices.
"Our annual survey found that, in aggregate, gender disparity exists for physician compensation," said Halee Fischer-Wright, CEO and president of Englewood, CO-based MGMA. "Knowing what factors contribute to the gender pay gap help us better understand and interpret the cause."
Highlights from the survey include:
Specialty area influences the disparity in total compensation with males across all specialty areas earning more than their female counterparts. Males practicing in primary care reported earning 17% higher compensation while males in specialty care reported earning 37% more than females in the same practice area.
Survey results show that the number of years in a specialty area may play a role in the gap in total compensation.
Males are paid more than 20% more than females in the specialty areas of family medicine and general pediatrics, but have an average of seven years more experience than their female counterparts who participated in the study.
As there are now more females graduating from medical schools than males, females represent a greater percentage of the population of physicians that are early in their career.
Productivity increasingly is a significant factor in the development of physician compensation packages. Males in invasive-interventional cardiology are making over 25% more than their female counterparts, but show 42% greater median work relative value units (RVUs), a measure of value used in the Medicare reimbursement formula.
Male general orthopedic surgeons make almost 50% more than their female counterparts with more than 80% greater median work RVUs. The large difference in the data may be due to the number of women in these specialty areas and how much experience they have.
Suzanne Leonard Harrison, MD, president of the American Medical Women's Association, says that experience and specialties alone do not account for the disparity in pay between the sexes.
"There are several studies that have looked closely at this, and even with those factors considered, women physicians are often paid less than men," Harrison wrote in an email exchange with HealthLeaders.
"Women, people of color, and other physicians with minority status are often not given opportunities for advancement, promotion, bonuses, raises and other forms of payment that those in the majority benefit from on a regular basis."
Harrison says the reasons for the lack of opportunities are "multifactorial," and "partly due to a systemic acceptance of this as the norm. In addition, the micro-aggressions contribute to an overall sense of being less valued."
In general, Harrison says, women are paid less than 80% of what men are paid for the same work, and are less often promoted to leadership positions in their practices, hospitals, and academic centers.
Female physicians' career advancement is further hobbled by their responsibilities for running the home and taking care of children and aging parents," Harrison says.
"Many make choices to work fewer hours to accommodate family responsibilities. While that choice is theirs, accommodations are often lacking to account for decreased time at work," she says.
"For example, an academic physician in a tenure-track position may work fewer hours (and is therefore paid less), but the 'clock' on tenure isn't lengthened to reflect the actual work being done and she is might end up putting in extra hours to keep up – but isn't paid for this. If she doesn't meet the requirements for promotion to the next academic rank within the assigned time frame, she might leave the institution rather than try to change the system."
"Another example would be a physician in private practice who works 75% rather than 'full-time' and yet sees the same number of patients and provides excellent care, yet she isn't paid the same because of decreased hours," Harrison says.
"There are endless examples, and women are socialized to be appreciative of what is offered rather than learning essential negotiating skills that would help them change the system."
"I would add that male physicians should also be balancing their professional and personal lives, and we'll know that we've reached pay and work equity when that standard is applied to both men and women," she says.
"I believe the answer to the issue is largely with administration and leadership, and those courageous enough to address pay equity in a transparent way."
Todd Evenson, MBA, chief operating officer at MGMA, also responding by email, says that "compensation drivers include, but are not limited to, specialty, years of experience, region, metropolitan versus rural, collections, and production (wRVUs)."
"By law, physician employment arrangements, require compensation at fair market value. Determination of FMV would include the drivers described above and gender would not be permitted as a factor."
"This," he says, "suggests gender bias is low."
John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.