September is Women in Medicine Month.
This past week, the American Academy of Pediatrics (AAP) highlighted 2 papers which studied the #genderdisparities amongst pediatricians. These studies found important #genderdifferences regarding BOTH income and households.
Study participants were 5-14 years post residency. These studies are important for the fact that the field of Pediatrics includes the highest percentage of women: 60% of practicing pediatricians and 70% of graduating residents are women. Overall reported mean annual income for pediatricians was $189,804. Before any adjustment, women earned ∼76% of what men earned which equated to $51,000 less.
Adjusting for common labor force characteristics such as demographics, work hours, and specialty, women earned ∼87% of what men earned which equated to $26,000 less. Adjusting for a comprehensive set of labor force (years since residency graduation, hours worked per week, specialty); physician-specific job (number of years in current job, number of patients seen per week, practice ownership); and work-family characteristics (marital status, number of children, choices made in job for their own children and periods of work reduction) women earned ∼94% of what men earned which equated to $8000 less.
The second study also studied #worklifebalance. Women were more likely than men to report having primary responsibility for 13 of 16 household responsibilities, such as cleaning, cooking and routine care of their own children. For laundry, 62% of women and 17% of men reported having primary responsibility, while 52% of women and 6% of men had primary responsibility for their child’s homework.
While outsourcing of household-related work has been suggested to help increase work-life balance, only about 1/2 of female pediatricians and 1/3 of male pediatricians reported outsourcing cleaning services. This number was even less for other household responsibilities.
Women were found to be less satisfied with their share of responsibilities relative to others and few women and men report being very successful at achieving work-life balance. Shocking, right?!
So What Does This Mean?
Regardless of what has been published and posted, women do not simply make less money because we work less hours than our male counterparts. That discussion point is simply false and does not accurately contribute to this discussion.
As female physicians, we study the same number of years, work just as hard and make the same sacrifices as our male counterparts. In fact, I would argue the sacrifices we make as female physicians are greater than our male counterparts. Female physicians may often delay starting a family due to the strenuous requirements of medical school, residency and fellowship (which are prime fertility years!) which can have adverse consequences for starting a family. After the time and sacrifice of female physicians, often times, I have heard: “She should go into a more family-friendly specialty and her husband can go into a more difficult specialty.”
Many people, especially within our Indian circle of family and friends, are shocked to learn that none of our children are interested in medicine…despite both of us being physicians. While medicine is the one of the noblest professions out there, I would not recommend anyone pursue medicine if they weren’t absolutely passionate about it. I think back to my 20’s. I often tell people, that aside from getting married in medical school, that decade was spent studying or spending most of my days and every third night in the hospital. See our recent podcast episode where I delve deeper into the topic.
These studies show that female physicians are not valued equally to their male counterparts. Aside from the sheer lack of respect, let’s look at this monetarily. How many female physicians have heard: “I don’t know why you work, you have a husband who is a physician (lawyer, business, finance, etc.)” While I am usually speechless when another physician feels that is an appropriate thing to comment on, if you look at this statement, you see how inappropriate it really is.
I have never understood the issue of how my husband’s profession should decide my salary. Does this mean that it is okay to pay a married female physician less money? What about the female physician who isn’t married, a single mom or is the primary or only breadwinner for her family?
On the Homefront
Regarding the splitting of household duties and achieving work-life balance, this issue is definitely not unique to just physicians. This issue transcends all careers.
How many times have you heard: “Well my husband helps out a lot” or “Oh that’s so great that your husband is babysitting!” Yes, I have actually heard both. Luckily for me, my husband and I share somewhat equally in the household. While I manage certain aspects of our household, he takes over those things that he enjoys and is good at…cooking, for instance! But again, since our call schedules vary, there are some weeks that one of us is doing the majority of household duties since one of us may be home more with the kids that particular day or week.
I found it interesting that only 50% of women and only 33% of men outsource household duties. As female physicians, most of us have a Type A personality (ladies, this is a compliment!) However, throughout our studies and training, we have done so much on our own that we find it difficult to ask for help—at least in my case. For my household, a reliable, trustworthy nanny who loves my children like her own is absolutely priceless. For us, this is the only way we could both do what we do as physicians.
But for those reading this, your husband/partner is not there to help—they are in it 50/50. While the household duties may wax and wane according to schedules, ages of children and outside interests, we must get away from the fact that we must ASK for help to manage our daily lives and that of our children. The mental burden of managing a household must be divided and shared. Period. I always encourage younger physicians that they need to make time to go to the gym, hang out with friends or just carve out time for themselves. Not only are our patients, husbands and children better for it, but WE are better for it.
While we are making strides in medicine, there continues to be #genderdisparities.
Both female AND male physicians need to be aware of the evidence so physicians can ADVOCATE for each other. All pediatricians, regardless of gender, deserve to be treated and paid equally. Use the hashtag #PayWomenEqually to share your story, help raise awareness and bring about change on this important issue.
Natasha K. Sriraman MD MPH FAAP FABM is an Academic Pediatrician and Associate Professor of Pediatrics at Children’s Hospital of the Kings’ Daughters/Eastern Virginia Medical School. She enjoys running, yoga and reading. Read her blog at www.NatashaMomMD.com and follow her Instagram @Natasha.Mom.MD. She lives at the beach with her Intensivist husband and 4 kids (3 human, 1 canine).
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Thank you for a wonderful article. I know many women doctors who are the only breadwinners for their families. The antiquated notion that a woman’s salary is supplemental is completely false and the reality is that many families are relying on that income to live on.