• Even in medicine, women are getting screwed

    I work in a medical specialty that is dominated by women. Almost all of the physicians in my section are women. Almost all of my fellows have been women. Pretty much every one of my mentees is a woman. So this study caught my eye: “Gender Differences in the Salaries of Physician Researchers

    Context  It is unclear whether male and female physician researchers who perform similar work are currently paid equally.

    Objectives  To determine whether salaries differ by gender in a relatively homogeneous cohort of physician researchers and, if so, to determine if these differences are explained by differences in specialization, productivity, or other factors.

    Design and Setting  A US nationwide postal survey was sent in 2009-2010 to assess the salary and other characteristics of a relatively homogeneous population of physicians. From all 1853 recipients of National Institutes of Health (NIH) K08 and K23 awards in 2000-2003, we contacted the 1729 who were alive and for whom we could identify a mailing address.

    Participants  The survey achieved a 71% response rate. Eligibility for the present analysis was limited to the 800 physicians who continued to practice at US academic institutions and reported their current annual salary.

    Main Outcome Measures  A linear regression model of self-reported current annual salary was constructed considering the following characteristics: gender, age, race, marital status, parental status, additional graduate degree, academic rank, leadership position, specialty, institution type, region, institution NIH funding rank, change of institution since K award, K award type, K award funding institute, years since K award, grant funding, publications, work hours, and time spent in research.

    You get the gist. They wanted to see if men were making more than women in research. They, of course, are. Men make on average $200 433, versus women, who make $167 669. There are some valid reasons for this.  Women are less likely to go into higher-paying interventional specialties than men men are (except for obstetrics and gynecology). Women may also be more less likely to work full time. So the researchers designed the study to account for these differences.

    Let’s get the usual caveats out the way. This was a complicated analysis that tried to compensate for the usual factors (excuses) people try and bring up when confronted with the fact that women make less than men. They accounted for demographic factors. They accounted for whether people were married or had kids. They accounted for other degrees, specialty, and leadership positions. They accounted for how many hours people worked, and the time they spent in research.

    I think you could make an argument they were too conservative. After all, there are more men in leadership positions than women, even in women-dominated specialties. More men get promoted than women. Unless this is totally deserved, it’s skewing the findings towards making a case that men should make more than women.

    But even if you ignore this, do you know what they found? Women are getting screwed. After controlling for all of the other factors, women were making a lot less less than men were. They used a Peters-Belson analysis, which allowed them to find that if you described a physician researcher, and then kept every other factor about him constant, but flipped his gender to female, that woman would make more than $12,000 less.

    This isn’t the first time I’ve covered this issue. The last time I did, a commenter used the results as “proof” that women are inferior to men. We have a long way to go, even in academic medicine.


    • ….and they both make more than me, a primary care doc.

      Gee, why are they complaining? Researchers seem to be doing well, better than most primary care docs I know.

      I’ve just seen this same argument made in this blog against docs who complain about their pay, so I thought it was a good time to bring it up here.

      • There’s a big difference between complaining about making too little, in general, and being paid less because you’re a woman.

        Those averages include surgeons and lots of subspecialists, so yes, they make more than you. I wouldn’t be surprised to find that many of the primary care researchers make less than primary care private practice docs, though.

        • Why separate out women in this consideration? I don’t care what the field is, if there are a group of people being paid less for equivalent work, it’s discrimination.

          • Uh, Ron. _You_ chose to become a primary care physician. That GPs get paid less isn’t discrimination, it’s a fact that you knew when you made that choice. If a woman made the same choices, did the same job, worked the same hours, and got paid less. That’d be discrimination.

            • Thank you for high lighting this study on behalf of your female colleagues. This pay disparity goes on in a multi-specialty/hospital group type practices, but is not well tracked. It is one of the many reasons I don’t work for one. It would interfere with my incredibly *upperclass* lifestyle. Note to self: become academic physician and only complain about the reimbursement of certain academic physicians….. Everyone else has chosen their lot in medicine and should not suggest there is injustice in the reimbursement structure.

    • They’re also adjusting away a major part of the bias. It’s not a coincidence that “specialties related to the care of children, women, and families” (their term) and fields that are traditionally not easy for women to enter (surgical) are paid much less – it’s institutional gender bias. If they consider these variables as being part of the gender gap (in the ‘causal pathway’), the gap grows by $15K!

      • Correct, and Aaron made that point. So, the analysis is conservative and still there is a gender gap.

        Some economists would call using control variables like the ones you mention “bad control.” if your hypothesis is correct, they’re really outcome variables, caused by gender (among other things).

    • Just think we could “bend the health care cost curve” if all the professionals in health care were women and paid 75% of what men are paid. It’s obvious, fire all the men and employ only lower costing women.

    • I have totalled things up for my group for the last 15 years. We pay our docs the same for the same work. The women have, on average, made less. The difference is relatively small and all accounted for by being out for pregnancy. If I include the couple of times I had to bring in locums to cover for pregnancy, it costs me more to have female employees.


    • In order for the results of the study to be credible, the regression has to accurately account for the magnitude of every variable that affects compensation.

      When looking over the paper, I noted that the authors measured productivity solely as a function of papers published. Perhaps it’s different in medicine (though I don’t actually believe this to be the case), but in the basic sciences the formula is productivity = number of publications x impact factor. Five papers in Nature, Science, or Cell puts a researcher on an entirely different plane than someone with fifty papers in The Journal of Applied Food Sciences even though the later has ten times as many publications.

      Insubstantial quibble – perhaps, but I think it illustrates how difficult it is to assign a single numerical value to something like “rank” or “productivity” and have the said value accurately capture the effect that the said variable has on compensation over the course of a career. Ditto for where you got your MD and PhD, where you completed your residency/post-doc, etc, etc, etc,

      Having said all of that – I’d be curious to know how if this model matches the experiences of those folks working in academic medicine. Does the model jive with your experience?

    • So now that we all agree that academic pediatricians are biased against women, Dr Carroll should gladly give up his high paying position to a woman or he should be forced to take a pay cut so that he will make no more money than a female professor in that department would make.