Why Are Female Doctors Paid Less?

College, medical school, residency and fellowship represent over a dozen years of education followed by years of day to day experience in preparation for what I do. The published gender pay gap report by Reuters by Anthony Lo Sasso of the School of Public Health of the University of Illinois at Chicago was surprising. The study is based on survey data from more than 8,000 doctors exiting training programs in New York.

According to their study, newly trained female doctors in the United States make nearly $17,000 less than their male counterparts, despite women choosing careers in higher paying medical specialties. They further reported that the gender gap in starting salaries for female doctors is widening, rising from a difference of $3,600 in 1999 to $16,819 in 2008.

According to Lo Sasso, "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."

Historically, women choose primary care fields such as family medicine or pediatrics, however, the percentage of women entering those fields dropped from about 50 percent in 1999 to approximately 30 percent in 2008, roughly on par with their male counterparts. According to the study, even though women doctors are choosing higher paying medical specialties, they still earned considerably less than men in 2008.

The team found the gap widened even after adjusting for choice of specialty, practice type or number of hours worked. Lo Sasso claimed that they weren't expecting to see this salary gap and were unable to account for the results. "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," Lo Sasso stated.

According to the National Committee on Pay Equity, "In 1963, when the Equal Pay Act was signed, women made 59 cents on average for every dollar earned by men (based on Census figures of median wages of full-time, year-round workers). By 2009, women earned 77 cents to a man's dollar, a narrowing of the wage gap by less than half a cent a year. Over a working lifetime, this wage disparity costs the average American woman and her family an estimated $700,000 to $2 million, impacting Social Security benefits and pensions."

When I was in medical school the number of women admitted to medical schools was limited. One of the many fears openly stated by the predominately male professors and physician teachers at the time was that as more women became physicians, the profession would be valued less; women would eventually lower the pay scale. Simultaneously, the National Organization of Women (NOW) was gaining power and advocating equal pay for equal job. It is amazing that some forty years later, the Lo Basso study seems to nullify that progress has occurred.

Personally, my experience with salary over the years has been fair. Currently, I am in a leadership position and recognize how important it is that salaries for professionals, paraprofessionals and all employees must be based on job performance and the value the individual and their position provides to the organization.

Gender, age, race, etc. are completely irrelevant to salaries. Lifestyle choices, however, are becoming more important to workers in all areas of employment and occasionally outweigh financial compensation.

Recently, flexibility in work hours is being requested more often by both men and women physicians. While the Reuters referenced study does not show why, Lo Sasso said the team cannot rule out gender bias as an explanation and thought it likely that female doctors were taking less pay in exchange for regular schedules or other family friendly benefits. "What we think it is essentially women trading off some salary for other non-monetary aspects of the job," he said.

Pay should be fair and proportional to the job performed. Less work or availability compared to their colleagues with the same job must be acknowledged appropriately and cannot be ignored when salaries are being equated. This referenced study is important and will most probably initiate other investigations and force a closer look at salaries and the actual basis on which they are determined.