Gender-Based Salary Inequalities Pervasive in Internal Medicine

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Policy-level changes may be needed to close the physician wage gap.
Policy-level changes may be needed to close the physician wage gap.

The wage gap between male and female physicians is substantive and policy-level changes may be needed to close that gap, according to research published in the Annals of Internal Medicine.

Researchers from the American College of Physicians conducted a cross-sectional survey of a nationally representative panel of non-student members across the United States. The investigators hoped to gain an understanding of physician compensation by gender among internists. Survey questions focused on respondents' compensation, demographic, and employment characteristics.

The survey was disseminated via email to 784 practicing physician-members on December 4, 2017; participants had 44 days to respond to the survey.

The survey response rate was 56.3%, and respondents were “representative of ACP's US practicing physician members,” the researchers noted. According to the results, 91% of respondents reported working full time; therefore, income analyses were centered on this group.

Data indicated that the median annual salary for men was $50,000 higher than that for women ($250,000 vs $200,000), with gender differences evident “across many demographic and employment indicators.” Overall, women earned less than men in every internal medicine specialty. The difference ranged from $29,000 for internal medicine specialists to $45,000 for subspecialists. An income differential of $29,500 was noted between men and women who were practice owners vs employees ($72,500 vs $43,000, respectively). Income disparities were also noted in solo practice and small government settings ($70,000 and $30,000, respectively). Gender-based salary differences were the same regardless of whether or not the respondent was a parent.

“Our study and others have documented that inequalities exist even within groups of physicians with similar professional and employment characteristics,” the researchers wrote. “With women making up more than one-third of the active US physician workforce, an estimated 46% of all physicians in training, and more than one half of all medical students, inequalities in compensation must be understood and eliminated.”

Study limitations include the use of data on reported vs actual income, and the findings' “uncertain generalizability to internists who are not ACP members and to other medical specialties.”

In an accompanying editorial, Barbara J. Turner, MD, MSEd, of the University of Southern California in Los Angeles, added that “substantive action is long overdue” regarding closing the wage gap.

“Achieving equal compensation for equal work will require systematic, multilevel initiatives that are long overdue,” wrote Dr Turner. “Women are increasingly becoming the lifeblood of the medical profession. The health of persons in the United States depends on women being treated fairly and equitably.”

References

  1. Read S, Butkus R, Weissman A. Compensation disparities by gender in internal medicine [published online August 6, 2018]. Ann Intern Med. doi:10.7326/M18-0693
  2. Saunders MR, Turner BJ. Unequal pay for equal work: where are we now? [published online August 6, 2018]. Ann Intern Med. doi:10.7326/M18-1879
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