—Roberta Gebhard, DO, hospitalist, WCA Hospital, Jamestown, N.Y., American Medical Women’s Association’s Gender Equity Task Force co-chair
Last year, a study in Health Affairs generated considerable interest when it found that male physicians newly trained in New York state made on average $16,819 more than newly trained female physicians in 2008, compared with a $3,600 difference in 1999.6 The authors controlled for specialty type, hours worked, designation of hours, immigration status, age, and practice location. And by focusing on starting salaries, factors such as job tenure, institutional rank, and job productivity didn’t come into play, signifying that the experiences of married female and male hospitalists with children differed less than one might presume based upon perceptions that women with families sacrifice work commitments to take care of their spouses and children.
“It is studies like this that are going to be critically important for us to move forward,” says Janet Nagamine, RN, MD, SFHM, a hospitalist at Kaiser Permanente Medical Center in Santa Clara, Calif., and an SHM board member who is assisting with the “Women in Hospital Medicine” session at HM12. “As we talk about a pay gap, we need to be more evidence-based.”
Studies that show a gender earnings gap even among highly skilled professionals don’t surprise researchers. The U.S. Bureau of Labor Statistics collects earnings data on hundreds of occupations, including physicians, and men outearn women across the board, regardless of educational requirements, says Mary Gatta, PhD, past director of gender and workforce policy at the Center for Women and Work at Rutgers University in New Brunswick, N.J., and current senior research scholar at Wider Opportunities for Women, a Washington, D.C.-based organization that focuses on opportunity equality for women.
The Gap that Won’t Close
So why, in 2012, do gender-based pay discrepancies remain?
How much people earn typically is not public information, so women often don’t know they aren’t being paid equally and, therefore, don’t have information on which to act, Dr. Gatta says.
“My opinion on it is women don’t know about the pay gap,” says Dr. Gebhard, co-chair of the American Medical Women’s Association’s (AMWA) Gender Equity Task Force. She recalls 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,” she says. “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, authors of the 2011 Health Affairs study posited that the influx of women into the physician workforce is reshaping the practice and business of medicine.6
“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,” says lead author Anthony Lo Sasso, a professor and senior research scientist at the School of Public Health at the University of Illinois at Chicago. “Remember, cash wages are but one part of the compensation package in any job.”
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Figure 1. Physician Compensation (>1 Year in Specialty) by Gender
Hoff’s study also uncovered gender differences in employment preferences, with men attracted to HM for the compensation possibilities and women for the predictable hours and lifestyle flexibility. For this reason, Hoff suggested, hospitalist employers can use different recruiting pitches for women than men and, to the extent they hire female hospitalists, save money (see “Negotiating Strategies for Better Compensation,” below).