Physician salary gender gap tops $36K

Male physicians starting out make more than $36,000 than their female counterparts on average, according to a new study in Health Affairs that compared starting compensation.

From 1999 to 2017, the average starting compensation for men was $235,044 and $198,426 for women. In more recent years, the gap actually widened compared to the earlier years.

However, a majority­­––60%––of the compensation gap was explained by specialty differences and hours spent in patient care. While there were differences in work-life balance, when controlled, these factors still didn’t explain the gender difference in salary over time, which has persisted.

“The implication is that there remain unmeasured factors that result in a large pay gap between men and women,” wrote first author Anthony T. Lo Sasso, from Depaul University in Chicago, et al. Researchers were based in New York and Chicago and analyzed male and female physicians who completed New York-based residency and fellowship training.

Researchers collected data of graduating residents from the New York Survey of Residents Completing Training from the Center for Health Workforce Studies of the University of Albany, State University, between 1999 and 2017. Since 2014, questions about work-life balance were added to the survey, such as asking respondents how to rate the importance of control over some job characteristics.

By 2017, the gender salary gap was $36,619, and several important differences emerged. For instance, women chose primary care fields more often and were less likely to choose surgical specialties less often than men. Women also less commonly reported very high amounts of time, at least 50 hours per week, in direct patient care, compared to men. Men reported having six or more job offers more often than women.

From 2014 to 2017, men had higher rates of partnered status and dependent children than women. Having children or being partnered did not affect gender difference in salary, they found. Within this subset, women were also more likely to rate work-life balance measures as very important compared to men.

While some of the gender gap was attributed to career goals with respect to work-life balance and chosen specialty, the gap appeared at starting compensation and did not account for the entire gap. And women’s preferences for work-life balance actually had no impact on salary. Researchers therefore concluded there were likely two other explanations for the salary differences.

“Either the stated preferences for greater control over work-life balance that women differentially expressed were not penalized in terms of starting pay, or despite their greater desire to control work-life balance attributes, women were not granted that control in their jobs,” Sasso et al. wrote.

Other factors are likely at play that impact female physicians’ salaries. And residency programs should be aware that these biases exist as new physicians are educated and trained, helping set expectations for graduating residents and educate them about salary negotiations.

“While it is apparent that women say they place a greater premium on control over work-life balance factors, this difference does not appear to explain the observed starting salary difference, conditional on other factors,” researchers wrote. “There may nevertheless exist workplace biases, whether intentional or unintentional, that differentially affect women irrespective of their individual stated preferences for work-life balance.”