Last week, The Dallas Medical Journal in their issue titled “Women In Medicine” asked local physicians if they believed a gender wage gap existed, and if so, what were the causes and what can the medical community do about it?
The uproar, which I’m sure many of you saw on social media, was started by an internist who said that a wage gap exists because female physicians do not work as hard as their male counterparts and choose to see fewer patients. However, while his remarks were completely uninformed and boorish, at best, there were other physicians who reinforced the stereotype that women get paid less since female doctors “can” work part-time since the male is usually the breadwinner of the family. These views are not only incorrect but also are not supported by data.
While many were very vocal on social media, the best thing we, as women can do, is fight . . .with facts. First, let’s debunk the myth that men and women are paid equally. I, personally, have had this conversation with administrators at institutions where I’ve worked, and they simply did not believe me. They were seriously in shock.
The Wall Street Journal looked at Census Bureau Data over 5 years and found that male doctors, working full-time made $210,000, while women physicians made 64% less ($135,000). And it is not only in the medical field, in fact, the study showed that other occupations that required higher education (financial advisors, compensation managers, judges) had large gender wage gaps, as well.
Next, we, as women physicians don’t work as hard. Whether we work full-time or part-time, let’s clarify something. We are working more hours than most male physicians. I have done it all while having 3 kids within 5 years: full-time, part-time and stay-at-home mom. As someone married to a critical care intensivist physician, I changed my career path when my kids were younger.
As many working women can attest to, none of us work “just” part-time. Instead we are working 2, maybe 3 jobs when you add in managing the household, kids, spouse, cooking and cleaning. Studies show that when we take time off/cut hours to take care of young children, women with higher education (graduate degrees) miss out on full-time benefits while being hurt more by this salary penalty.
A recent NY Times article shows that even though there are more women earning college degrees (and entering medical school, for that matter), the number of women in the labor force has plateaued since the 1990’s. Why? Because despite our higher education, motherhood is a constant juggling act and, is in fact, much harder than expected. Also, many women felt that returning to our career was ‘not good’ for the child/family and thus, stepped back to care for their family. While women continue do to more paid work, studies show that men have not increased their childcare and housekeeping to the same extent, exacerbating the mismatch of managing a household.
This study didn’t address the judgment among women, that many female physicians face, when we work long hours and often are away nights and weekends, and can miss family events. When I was torn about returning to fellowship when my first born was only 6 months old, I was told: “good mothers don’t work” and “I don’t know how you can leave your own child to take care of other kids.”
Next, let’s address the lack of maternity leave and the lack of family-friendly policies in the United States. While breastfeeding support and maternity leave has slowly improved, the United States is severely lagging behind. In fact, we are 1 of only 5 nations, the ONLY developed nation, that does not provide paid maternity leave.
Finally, let me address our skills and the quality of care we provide as women physicians. A recent study of almost 600,000 cardiac patients showed that those who were treated by a female doctor received better care and had lower mortality rates. Another study showed that patients treated by a female physician were less likely to be readmitted to the hospital, and also had lower mortality rates.
Researchers at Johns Hopkins showed that female primary care doctors spent more time listening to their patients than their male counterparts. Male physicians interrupt a patient within 47 seconds to redirect them, while female physicians waited an average of 3 minutes before interrupting the patient. But this increased time comes with a cost. Since we spend more time with patients, we are frequently running behind which translates into a longer day. And in the era of medical care dictated by administrators and insurance companies, those physicians who see more patients and bill more are the ones who are rewarded.
As women physicians, we came together quickly to address these ill-informed comments from an unprofessional colleague. But we have much to do as we continue to fight the inequity we face in the workplace. And it doesn’t affect just physicians. Women in other professions are also adversely affected. We also need the support of our male colleagues to address wage transparency because unlike other industries, the medical profession doesn’t openly discuss salaries. Only then can we, as women physicians, become proactive about negotiating salaries.
It is not only about extra income, it is about eliminating an unconscious bias that exists in medicine. While Women’s Rights are front and center within the political and legislative realm, we have to continue to focus on the work that needs to be done. Whether it’s wage discrimination, sexual harassment or the paucity of maternity-leave policies, our voices are much stronger when we all work together, physicians in different specialties, women from different careers.
‘Alone we can do so little, together we can do so much.’ ~Helen Keller
Thank you, Natasha. The data is clear! Women in White Coats have better outcomes, yet even when the variables of hours work, productivity, experience are accounted for women in medicine are getting paid less for the same work and as such are being treated as second class citizens. This is completely unacceptable and it is time for change. Women in White Coats, let’s join together to bring about change. Let’s share this on social media, demand transparency in pay and write letters to the editor to bring about change.
The gender wage gap is actually the product of a vast number of factors including occupational choice, number of antisocial hours worked, personality traits (in negotiating salary), age, experience, geographical location, willingness to relocate and about a dozen other factors. The degree to which gender discrimination plays a role is indeterminable but based on the statistics it is likely to be close to negligible. What we are seeing here is the result of the free choices of men and women. This has been demonstrated with a high degree of reliability and replicability by multivariate analyses in other fields. I expect the same would apply to the medical profession.
The difficulty with trying to eliminate any such wage gap is that you’re going to run into the problem of having to define exactly what constitutes ‘equal work’ for which people can be ‘equally paid.’ If you think that is going to be a simple task then you just haven’t thought it through. Medicine is supposed to be ‘evidence based’ so I suggest you look at the evidence and actually try to understand before you start getting outraged about the problem.
Yes, that is just so much painful.