A new study shows that female doctors make less than their male counterparts on their first day on the job. Researchers estimated that the pay gap adds up to $2 million over the course of a 40-year career.
The first estimate of the cumulative impact of pay gaps in medicine can be found in the survey of more than 80,000 physicians.
Christopher Whaley, the lead author on the study and a health economist at the RAND Corporation, said that there is a sizable gap from Year 1 to 40.
Survey data was collected between 2014 and 2019. He said that the pay gap has probably widened since then, as the Pandemic has driven women out of the workplace to take on child care and other household responsibilities, lowering their cumulative career earnings.
Dr. Whaley said that it was likely going to accelerate physician burnout. That is going to make the pay issues worse.
The researchers looked at salary data submitted to Doximity, a social network that claims to reach 80% of doctors in the United States. Men and women with the same amount of experience earned the same amount of money, but women made more.
The researchers controlled for a number of factors that influence pay, like a doctor's specialty, type of practice and patient volume.
More men become surgeons than women go into primary care. Women spending more time with their patients leads to a lower volume of services and procedures that can be billed for.
Some of these measures are likely manifestations of systemic bias or discrimination, according to Dr. Reshma Jagsi, a radiation oncologist and bioethicist at the University of Michigan medical school. Studies show that women are less likely to apply for jobs in medicine that are held by men. Women in academic medicine are less likely to hold leadership positions.
The estimated pay gap would have been much larger if the researchers had not controlled for these variables. Dr. Whaley said their numbers would double.
The highest and lowest wage gaps were found among surgeons and primary care physicians.
Although the gaps have narrowed over the past few decades, almost all professions still pay women less. The gap is wider among health care practitioners than among people in engineering jobs.
The new study didn't include data on people who identify as nonbinary or trans, and didn't specify the race of the survey respondents, which previous research has shown is a big factor influencing physician pay.
Dr. Whaley said that salary information by race is not recorded systematically. I think that is a data limitation.
The study found that the salary gaps began at the beginning of a doctor's career and continued until around Year 10. The gap remained stable for the rest of their careers, with women never catching up to men.
Dr. Snigdha Jain, a physician at the Yale School of Medicine who was not involved in the study, said that the finding was unsurprising. Women physicians who are in the prime of their reproductive years when they start practice, experience insufficient maternity leave, inadequate support on return to work and a disproportionate burden of child care in the subsequent years.
Women graduate from medical school at the same rate as men, but only 36 percent of physicians are women. Dr. Jain said that the new study couldn't capture the effects of the leaky pipeline on women's cumulative earnings because it didn't follow individuals over time.
Dr. Whaley said that the wage gap could be narrowed with policy changes that affect younger doctors. Making salaries more transparent and offering more paid family leave could help women earn their fair share, he said.