Big Bucks, Few Women: Peeking Into the Pay Gap Among Medical Big Shots

Did you know that fewer women are on the list of doctors paid the most money by drug and medical device companies? According to a ProPublica analysis of new data released by the federal government, over 90% of the 300 doctors who collected the most money for speaking and consulting are men. This brings to light the growing body of evidence suggesting that male and female doctors are paid differently and even practice medicine differently, although the reasons for this discrepancy are not entirely clear.

It might be that men are more willing to accept payments from drug companies than women, or that drug companies are more likely to make offers to male doctors. Alternatively, it might be that male doctors are just much more likely to be in the senior positions or medical specialties that appeal to drug companies.

Even in primary care fields, men dominated the list of the 300 highest-paid speakers and consultants. The new federal data has plenty of caveats, but the broad finding is consistent with dollars for Docs, which tracks payments made by 17 drug companies over four years.

It is quite clear from the research that women in medicine earn less than men. A study last year in JAMA Internal Medicine found that the median earnings of male physicians exceeded those of female physicians by over $56,000 between 2006 and 2010. This gap was found to have increased in later years even after factoring in inflation. The data was adjusted for hours worked and for years of experience, but not for physician specialty. Some specialties, like dermatology or orthopedic surgery, tend to pay better than general practice.

Furthermore, a 2011 report in the journal Health Affairs discovered a gender disparity among doctors who recently completed their residency training programs. This disparity persisted even after taking into account doctors’ choice of specialty.

Gender differences are also apparent in the data released for Medicare’s payments to physicians. An analysis by the website Nerd Wallet found that men were paid 88% more than women in Medicare reimbursements in 2012. Men saw more Medicare patients, performed more services per patient, and were paid more money per patient. This gap persisted within specialties in which women have a larger presence, including obstetrics and gynecology.

In response to this gender disparity, the American Medical Women’s Association created a Gender Equity Task Force to work on reducing the gap between male and female physicians.

Anthony T. Lo Sasso, a professor of public health at the University of Illinois at Chicago, was the lead author of the 2011 Health Affairs article. He noted that women have tended to work in primary care fields, such as internal medicine, family medicine, pediatrics, and obstetrics-gynecology, which provide fewer opportunities for consulting and speaking work.

In 2010, for example, women only made up 4% of orthopedic surgeons in the United States. (Thirty-nine male orthopedic surgeons — and no women — were among the 300 top speakers and consultants.) Lo Sasso suggests that the notion that female physicians may be more willing to trade off some income for greater flexibility to improve the work-life balance may be a consideration.

Consulting and speaking engagements take up even more time after working hours. “If they’re willing to forgo some salary in order to get some predictability and to balance work and nonwork life, it wouldn’t necessarily be surprising to see them not take up these additional consulting gigs,” he said.

Data on gender disparities among physicians requires further study to better understand and address this issue. Anupam B. Jena, a professor of medicine at Harvard Medical School and a doctor at Massachusetts General Hospital, said that adjusting for physicians’ ages and specialization may reduce the extent of the disparity in the data but may not eliminate it entirely. “I wouldn’t be surprised to see that even when you adjust for all these things, you still see more payments going to men than to women,” he said.