A recent study appearing in the February issue of Health Affairs found that 2008 starting salaries for male doctors outstripped the starting salaries of their female counterparts, by an average of $16,816 a year. Further, the gap has grown steadily since 1999, when the data showed a difference of only $3,600 in starting salaries.
The gap exists even after accounting for gender differences in choice of specialties entered, practice type and hours worked.
“In 1999 we found very small and statistically insignificant differences in starting salaries,” said Anthony Lo Sasso, a professor and senior research scientist at the School of Public Health of the University of Illinois at Chicago and lead author of the study. “What surprised and continues to puzzle us is the ability to explain away the difference in salary based upon the specialties women go into versus men, or differences in hours worked, dissipates over time. So you go from about $3,500 in difference in 1999 to almost $17,000 in just 10 years.”
The study data was compiled by th State University of New York, which has collected the data of doctors leaving residence programs in New York for the past 10 years. The state is home to 1,073 residency programs, according to data from the Association of American Medical Colleges – by far the most of any state in the country. The number of physicians in the survey sample comprised 4,918 men and 3,315 women.
Women had lower starting salaries than men in nearly all specialties. In 1999, new women physicians earned $151,600 on average compared to $173,400 for men – a 12.5 percent salary difference. That difference grew to nearly 17 percent by 2008, with women starting out at $174,000, compared to $209,300 for men.
To try to understand why such a big difference was shown, La Sasso and his co-authors looked to determine if the data was being affected by whether women were broadly choosing to start their medical careers in markets with lower costs of living and hence lower salaries. But cross-referencing zip codes of where the doctors worked with cost of living indexes had no effect on the discrepancy.
“A little side story to the research we found is that you hear stories about physicians leaving primary care, and national data support that, and that is no surprise,” said Lo Sasso. “What really surprised us, at least with our data, is that the men by 1999 had already left it, but half of women were in primary care. But then, over the course of this time period, it dropped down to where men are. So it is really women who are leaving primary care.”
The paper considers other reasons why the change is happening. “We know it is occurring, but we aren’t able to explain exactly why it is,” Lo Sasso said.
The researchers rejected the notion that somehow discrimination against women doctors has gotten worse in the past 10 years, though LoSasso admits they don’t have specific data to support that. They also considered whether women might be “worse negotiatiors” than men for starting salaries, but that would also suggest that women have become worse over time, since there was little difference in salaries in 1999 – again a supposition the researchers rejected.
Instead, the most likely explanation is that women may be sacrificing salary to for non-monetary aspects of their jobs.
“A better call schedule, or no call, could be worth a lot,” said Lo Sasso. “But you would have to give up something to get that, and what you might give up is salary. Greater flexibility in hours, the predictability of those hours and the flexibility of hours is another trade that women may be asking for in greater numbers than men.”
Unfortunately, the data Lo Sasso has at his disposal is not sufficient to answer the questions the study raised.
“Hopefully, someone else can find a way to collect this information to answer why this gap is widening,” he said.