Women are a huge role in medicine, but when it comes to pay, they are still trailing men; and it is getting worse. Right away, many chalk the gap up to choice of specialty, work hours, or practice setting. However, Anthony T. Lo Sasso, Michael R. Richards, Chiu-Fang Chou, and Susan E. Gerber considered these factors. "The unexplained trend toward diverging salaries appears to be a recent development that is growing over time," wrote Sasso, Richards, Chou, and Gerber. 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. The authors controlled for age, designation of hours, hours worked, immigration status, practice location, and specialty type. Lisa Ryan notes that by the authors focusing on starting salaries, factors such as, institutional rank, job tenure, and job productivity did not come into play; signifying that the experiences of married female and male hospitalists with children differed less than presumed. It has been proven: Female doctors are paid less than their male counterparts are. Stacy J. Williams, Laura Pecenco, and Mary Blair-Loy, from the Center for Research on Gender in the Professions at UC San Diego, found that women surgeons and physicians made 79% of what their male colleagues earned. Williams, Pecenco, and Blair-Loy found that “the income disparity between men and women physicians remains even when controlling for age, specialty, and hours worked.” So Why, In 2018, Does The Pay Gap Remain? “My opinion on it is women don’t know about the pay gap,” according to Dr. Roberta Gebhard, co-chair of the American Medical Women’s Association’s (AMWA) Gender Equity Task Force. She recalled a salary negotiation lecture she helped lead after which a woman finishing residency raised her hand to say she was joining a faculty where everyone was paid the same. “The entire room just groaned….Clearly, women out there think everything is fair and people are paid the same. They don’t know they’re being paid less.” In trying to explain the widening pay gap, Sasso, Richards, Chou, and Gerber suggested that the influx of women in medicine is reshaping the practice and business: The notion we suggest is that the increasing gender gap can be explained by new women physicians increasingly demanding non-pecuniary aspects of their jobs, and because of the greater aggregate presence of women in the physician labor market, being able to get it….Remember, cash wages are but one part of the compensation package in any job. Women also find themselves in a double bind when negotiating higher compensation. Some suggest a pay gap exists because women are not negotiating for themselves, however, research shows women tend to be perceived as less likable when they are more assertive about increasing wages. Subtle forms of gender discrimination continue to exist in workplaces; such as the belief that men have a family to support, so they should be paid more, and that women are in the workforce just for extra money, even though recent data show that women’s income is key to families’ well-being. Does Increased Flexibility Account For The Pay Gap? As earnings data and research show that the gender pay gap lingers, several possible explanations for this pay gap have been raised. More problematic is pinpointing why the gap will not close. Explanations range from ignorance and trading in compensation for other job benefits to women’s lack of negotiating skills to subtle gender discrimination. One explanation that has been thrown out, due to in part the Plano physician, Dr. Gary Tigges’ recent commentary regarding the pay discrepancy is a result of women trading flexible work schedules for monetary compensation. Parija Kavilanz, with CNN Money, wrote an article that does a good job detailing the pay gap discrepancies. 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) were. For a 50-hour workweek and 50-weeks a year, that is about $20 an hour less than other physicians with the same training and hours worked. Women in medicine attend the same medical schools and undergo the same years of rigorous training as their male counterparts, but female doctors in the United States are STILL earning significantly less than their male peers – and the pay gap is only growing wider. Dr. Theresa Rohr-Kirchgraber says it perfectly: "Closing this pay gap isn't just about getting extra income. It's about eliminating an unconscious bias that exists in medicine.” Potential Solutions The wage gap is not caused by fewer hours’ worked or lower performance. So how can we close the gap for the next generation of women in medicine? First, we need access to more data. Equal pay laws, such as the Lilly Ledbetter Fair Pay Act, exist at the federal level. However, work still must be done to enforce these laws to make a real difference. When it comes to physicians’ salaries, transparency will help us gauge where we stand and identify areas in need of improvement. We need to help each other. Senior women in medicine need to reach out to those just out of medical school to share their experiences, advice, and support. As women in medicine, we have achieved quite a lot, and by leveraging the past, we can build a better future. “The pay gap is just one of the many disparities women in medicine face,” adds Roshini Pinto-Powell. “Promotions are scarce, leadership opportunities are often lacking, and we see little to no recruitment into higher-paying specialties. All of this means lost opportunities for higher salaries, which only further feeds the pay gap.” What do you think?