The gender pay-gap is increasing

Women are taking a greater role in medicine today, but when it comes to pay, they're still trailing the men. And it's getting worse.

The current issue of the journal Health Affairs takes a look at average starting salaries for approximately 8,000 physicians leaving residency programs in New York from 1999 to 2008. The result: female physicians earn nearly $17,000 less than their male counterparts.

So right away we chalk it up to choice of specialty, work hours, or practice setting. But the researchers took those factors into consideration. "The unexplained trend toward diverging salaries appears to be a recent development that is growing over time," writes the study's authors. In 1999, female newly trained physicians in New York were paid $3,600 less than newly trained male physicians even if they worked the same hours in the same specialties. By 2008, the gender pay gap had grown to $16,819.

Does increased flexibility account for the pay gap?

Several possible explanations for this pay gap were raised in the original article, and many more have since been debated across the web. We wanted to look at one specific possibility to see if it could explain the gender pay gap in physician salaries. Specifically, we wanted to know if the pay discrepancy is a result of women trading flexible work schedules for monetary compensation.

MomMD ran a poll from February 11 to February 16, 2011. The poll asked:

Women physicians: have you negotiated better benefits or work hour flexibility (not fewer hours) in exchange for lower pay?

The response options were simple: "Yes" and "No."

Of the 50 women physicians who responded, about two-thirds (66%) said "No" and one-third (34%) answered "Yes."

For flexible work hours to explain the pay gap it would mean that the 34% who did take lower pay for flexible work hours were paid on average about $49,500 less a year than other physicians (both male and female). For a 50-hour work week and 50-weeks a year, that's about $20 an hour less than other physicians with the same training and hours worked.

Twenty dollars an hour seems like a lot of money to give up for flexibility, but it might actually make sense. After taxes, that's almost exactly what a babysitter costs in major cities ($12-$15/hour). So to many it might make sense to forgo the income and not pay for childcare.

But if flexible work schedules and better benefits were the only cause for the pay gap, there would be two groups. One group of women physicians, about 60-70% of them, getting paid similar wages as men and another group, about 30-40% of all women physicians, getting paid much less. It is not clear from the original study if this was the case.

Non-negotiated benefits

One possibility is that 34% underestimates the number of women who choose flexibility over income. The poll asked if flexibility was "negotiated," but some Mom MDs describe choosing a more flexible job from multiple job opportunities. So the tradeoff might be happening without negotiations. This was clear from many of the discussion posts on the gender pay gap topic in the MomMD physician forum.

Other reasons for the growing pay gap

Among the other possible explanations for the growing pay gap:

Are women physicians opting out of on-call service and therefore missing out on that compensation?

Do female physicians spend more time with patients and therefore see fewer cycle through compared with their male counterparts?

Gender discrimination is always a possibility, though the study's authors stop short of calling it that. According to the study's author Anthony Lo Sasso, a senior research scientist at the University of Illinois at Chicago's School of Public Health, and his coauthors, women had lower starting salaries than men in nearly all specialties.

These findings are particularly significant when considering that women not only represent half of all U.S. medical students and residents, but also that women are comprising a growing percentage of practicing physicians.

Read the study

Look up physician salaries by specialty and geographic location. Doctor salaries can also be viewed in association with the MomMD physician jobs board.

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