Would you believe that taxpayer dollars compensate the average male doctor 88 percent more than the average female doctor? A new study sheds light on this shocking Medicare gender pay gap and its what drives this inequality.
The study analyzed over 500,000 doctors receiving Medicare reimbursements. Its findings suggest inconsistencies in the ways male and female doctors practice medicine -- and this results in a big pay gap.
Male doctors see more patients than female doctors. Male doctors also perform more services per patient than female doctors across nearly all specialties. As a result, they also earn more money per patient treated.
"This certainly begs the question of whether men and women practice medicine differently. The bottom line is patients may experience higher costs through doctors who bill for more services per patient," says Dr. Fisayo Ositelu, Medical Director of NerdWallet Health.
Those costs may not come just in the form of higher medical bills. Research by Patient Safety America estimates that at least 210,000 patients die each year due to preventable hospital errors; more exposure to the medical system means a higher risk of harm due to error.
Does Medicare pay female doctors unfairly?
Medicare pays doctors the same amount for a given service, but doctors who perform more services per patient will certainly make more money. The study found that male doctors see 60 percent more patients and perform an average of 5.7 services per patient, while female doctors perform an average of 4.7 services per patient.
On top of that, female doctors make up fewer than 10 percent of doctors in high-paying surgical fields like cardiac, orthopedic, and neurosurgery. They also work fewer hours across the board, according to a 2012 Yale study published in the Journal of Human Capital.
All of these differences add up: the average male doctor receives $118,782 in annual Medicare reimbursements, while female doctors receive an average of just $63,346.
The good news is that the tides are changing -- albeit slowly -- for women in high-paid surgical specialties, according to 2011 research published in the Journal of the American College of Surgeons. The study reports a slight uptick in females entering surgical residencies, which will lead to more women in these higher-paying fields.
Despite gradual improvements in correcting gender discrepancies in specialty choice, it'll be slow going for a while. A study by Ying Zhuge and colleagues points to institutionalized sexism in academic surgery fields. The report notes that sexism may be either subtle or explicit, but that women still report discrimination more frequently than do men, and lack of female mentors in surgery influences the decision to specialize.
While most of the gender differences are explained by gender differences in practicing medicine, the study highlights a larger issue. Medicare, like some other insurers, uses a fee-for-service (FFS) system that incentivizes doctors to order more services in return for more reimbursements. For patients, this can mean additional financial costs and more (potentially unnecessary) exposure to the health care system.
The true silver lining of these findings lies in the fact that studies such as this one can now be executed -- physician-specific Medicare reimbursement data is now available for public consumption for the first time, and, as such, offers fresh insights in the field of health care. As more data is released and pricing transparency in medicine is pushed to further limits, patients will be better empowered to make better decisions about their own care, which often means fewer tests and procedures.
It also means shopping around for health care -- a first for many Americans. Thanks to Medicare and other similar datasets, tools are popping up all over the web to help patients compare care providers based on measures like cost and quality before making a choice. The Best Hospitals tool allows patients to see average charges, patient volume, and satisfaction ratings for nearby hospitals. Other websites like BetterDoctor use patient feedback and other data to help patients choose high-quality care providers, while Healthcare Blue Book compares providers' average price for a particular service to a "fair price" for that service.
As more and more data becomes available, only time will tell how pricing transparency can change the future of health care.