They excel through four years of rigorous undergraduate study, then battle their way through four more years of tough, tough medical school. They cram to pass their medical boards and grind through exhausting internships. They also pursue years more of exacting, sleep-deprived training in residencies and fellowships.
But, wait a minute: Women doctors earn over a professional lifetime an estimated $2 million less on average than their men counterparts? They experience gender pay gaps of 25% to as much as 50% over the course of a 40-year career?
Yes, those are the disconcerting findings of published research that analyzed data from surveys of 80,000 doctors between 2014 and 2019, the New York Times reported:
“The researchers analyzed self-reported salary data submitted to Doximity, a social network similar to LinkedIn that claims to reach 80% of doctors in the United States. Comparing wages between men and women with the same amount of experience, the researchers estimated that, over a simulated 40-year career, male physicians earned an average of $8.3 million while women made roughly $6.3 million — a nearly 25% difference.
“In their calculations, the researchers controlled for an array of factors that highly influence pay, like a doctor’s specialty, type of practice and patient volume. More men, for example, become surgeons — the highest paid of all physician specialties — whereas more women go into primary care. And women have been shown to spend more time with their patients, leading to a lower volume of services and procedures that can be billed for. Some of these measures are ‘themselves the likely manifestations of systemic bias or discrimination,’ said Dr. Reshma Jagsi, a radiation oncologist and bioethicist at the University of Michigan medical school who was not involved with the new report. For example, studies have shown widespread bias against women applying for jobs in medicine that are traditionally or predominantly held by men. And women in academic medicine are less likely to get big research grants or hold leadership positions.”
The researchers told the newspaper that the gender pay gaps for doctors have only grown due to the coronavirus pandemic, “as [it] has driven women in many fields, including medicine, out of the workplace to take on child care and other household responsibilities, lowering their cumulative career earnings.”
For women, stark career and financial choices present early. Women are in their prime childbearing and rearing years just as they start to wrap up the daunting toil of their medical education and training. The New York Times earlier had reported that women doctors experience a painful professional reality that many of them struggle with infertility or the inability to carry a baby to full term. The subhead on that previous piece explains much, reading:
“Physicians are raising awareness of the reproductive toll that work stress, long hours, sleep deprivation and years of training can exact.”
Because medicine for so long has been a male-dominated profession, young women doctors have not received the workplace support they need in early career, meaning a dearth of good options with childcare, scheduling flexibility, and leave — without financial and long-term consequence.
When women, as they do in medicine and far too many other fields, start by getting paid less, don’t get the same opportunities as men colleagues do to become specialists in high-paying areas (like various kinds of surgery), lack advancement opportunities accorded male peers — well, as the researchers found, they start behind and fall further and further so over decades of work.
This isn’t just terrible for talented women doctors. It has big, bad outcomes for patients and the U.S. health care system, which is confronting a graying nation with rising health care needs and a major shortage of medical staff, notably doctors. Experts have forecasted the United States may see shortfalls of as many as 125,000 doctors by 2034, even as gender pay gaps and gender attrition take a measurable toll. As the New York Times reported:
“While roughly the same number of women graduate from medical school as men, women make up only 36% of working physicians.”
That’s a problem prescription for American medicine’s future.
In my practice, I see not only the harms that patients suffer while seeking medical services, but also their struggles to access and afford safe, efficient, and excellent health care, including mental health support. This has become an ordeal due to the skyrocketing complexity, uncertainty, and cost of treatments and prescription medications, too many of which turn out to be dangerous drugs.
Women, in particular, long have struggled and suffered mistreatment at the hands of experimenting male doctors. And studies show that women patients — indeed, patients of all genders — fare better with women doctors.
So, why doesn’t the profession, especially medical educators, boost women’s participation in medicine? The Lily, a section of the Washington Post that focuses on women’s issues, has reported on ways that practitioners — notably women themselves in medicine — are doing this.
They deserve more support, as do those who are trying to make medicine more inclusive by battling racial discrimination that, for example, persists in making orthopedic surgery a specialty dominated by white men.
The point here is not to be faux “woke,” but to keep in mind the people whom medical personnel are here to help: patients. They are more diverse and have great needs for care that is much safer, more accessible, and affordable. Our county is built on the promise of equality, and in the wealthiest nation in the world, health care must be a right not a privilege. We can only see that happen when we put our best efforts into ensuring that we have an abundance of talented and inclusive medical staff, especially doctors and nurses.
