Women Doctors Face Major Compensation Gap

Even though women doctors tend to have better outcomes for their patients, they are paid significantly less than their male counterparts across specialties.

That gender gap was 25.2 percent in 2018 or about $90,490 a year, according to Doximity, an organization that tracks physician compensation. The greatest gaps were in pediatric pulmonology (lungs), otolaryngology (ear, nose and throat), urology, radiology and pediatrics. The smallest gaps were in hematology (blood), rheumatology, radiation oncology, thoracic (heart) surgery and plastic surgery.

“For every single type of medical specialty, we see women receiving quite a bit lower pay even when we adjust for things that impact pay, such as hours worked, working for a hospital, type of work,” says Chris Whaley, a professor at the University of California, Berkeley, and a policy researcher at the Rand Corporation who led the Doximity research.

A recent study by the American Academy of Pediatrics (AAP) found even in practices where there are the smallest gaps, women pediatricians earned about $8,000 less per year than their male counterparts—that’s hundreds of thousands of dollars in lost wages before retirement age. And the study found female pediatricians are more likely to report having the primary responsibility for 13 of 16 domestic tasks, such as cleaning, cooking and routine care of their children.

Six of every 10 U.S. pediatricians are women; seven in 10 graduating pediatric residents are women, according to workforce data.

“Compared to past generations, pediatrics has made strides in increasing workplace flexibility, yet women still face challenges with professional advancement,” says Kyle Yasuda, M.D., president of the AAP.

What’s keeping women behind financially?

The average age of students entering medical school is 24 and women now comprise the majority of medical school students. They must complete four years of medical school followed by three to seven years of residency training depending on their specialty, which overlaps significantly with prime years for having children.

The gender gap in full-time employment starts at 9.6 percent for first-year doctors and balloons to 38.7 percent by five years.

A recent Association of American Medical Colleges article cited a study that found almost 40 percent of women physicians go part-time or leave medicine within six years of completing their residency. “The emergence of this gap so early in physicians’ careers may contribute to later gender inequities in compensation and promotion and suggests the importance of expanding social and institutional support for work-family balance moving forward,” says Elena Frank, Ph.D., director of the Intern Health Study.

A study investigating time spent on parenting and domestic responsibilities revealed married male physicians spend seven more hours at work and 12 hours less per week on parenting or household tasks than their female counterparts.

The majority of female residents elect to delay childbearing until after they have completed their training for a number of reasons. The demanding schedule with a grueling 80-hour work week is not conducive to getting pregnant, having a healthy pregnancy or raising a child. A survey by the American College of Surgeons found two of every three women surgeons report negative attitudes from peers and faculty that influenced their childbearing decisions.

There are multiple studies highlighting increased complication rates during pregnancy and childbirth for resident physicians compared with the general population, because of the increased physical and emotional stress these women endure during their training.

Parental leave is another concern. Most specialties do not permit residents to take more than four weeks of leave for any reason during a single academic year. The average duration of paid parental leave at seven of the top 15 graduate medical institutions was 6.6 weeks, compared with 11 weeks at the Working Mother 100 Best Companies. Most specialties require residents to make up time beyond the four weeks of leave to ensure clinical competence, which causes timing issues with progressing to the next level of training or starting a new job after graduation.

Once moms return to work, they face continued challenges. For example, onsite childcare support is available at only 145 of the 543 hospitals with accredited Internal Medicine residency programs, and limited daycare hours might not be compatible with a resident’s schedule.

As with many careers, re-entry into the workforce after a period of prolonged leave is difficult. But specific to medicine is the issue of licensing, with most states requiring a safety and competency evaluation after a period of leave ranging from one to 10 years, a process that can cost up to $20,000 in fees. So taking as little as a single year off from work can set physicians back thousands of dollars in evaluation charges.

But with all these gaps for women doctors, they still have better patient outcomes than male doctors. An article in The New York Times in 2018 cited a study of more than 580,000 heart patients admitted to emergency rooms over two decades. The mortality rates were significantly lower for patients treated by female physicians, while female patients treated by male doctors were least likely to survive. In 2016, a Harvard University study of more than 1.5 million hospitalized Medicare patients found they were less likely to die or be readmitted when treated by a female doctor.

Even though, according to these two studies, female doctors often have more successful track records, many of them are underpaid and face huge obstacles in their efforts to have families and work. When they aren’t allowed to reach their full potential, patients are the real losers.