Industry Voices—The pay gap for male and female doctors is ridiculous. Here's what can be done about it

The data on pay inequity for female physicians is, frankly, damning.

Across all medical specialties, there are dogged disparities between what females and males are paid. For instance, in pediatric pulmonology, women earn 23% less than men. In both ENT and urology, women are taking home 22% less pay than their male counterparts. Depending on the specialty, this results in a disparity of nearly six figures in salary and compensation.

To hear hospitals or healthcare systems tell it, there are some perfectly logical reasons for physician salary gender inequity. One of them is that women are more likely to choose lower-paying specialties such as pediatrics, family medicine and psychiatry than men. This, of course, ignores the fact that the pay disparity exists even within specialties—not just between them.

Some other chestnuts include the contention that women physicians work fewer hours than their male counterparts and those female physicians spend more time with the patient and are thus less productive. Spending more time with the patient means fewer overall patients treated on any given day, which means less revenue for the hospital or healthcare system.

Let’s take these one by one. With regards to female physicians working fewer hours, data shows that significant earnings disparities between male and female physicians occur even when the number of hours worked are accounted for. So, hours worked doesn’t provide much justification for the gap.

How about the argument that women physicians spend more time with the patient? This isn’t a strong argument to justify paying someone less either, because profitability isn’t the only metric that matters in healthcare. Hospitals are also evaluated on patient satisfaction, and physicians who spend more time with their patients generate higher satisfaction scores.

As dubious as the reasons may be for the disparities, there are significant ways in which female physicians might inadvertently be undercutting themselves financially without even realizing it. This especially happens whenever they try to assess a fair salary by asking their physician colleagues how much they make and using that as a reference point.

That turns out to be a mistake because the people in their immediate professional and social circles likely fall into a similar demographic category—which is to say, they’re probably female physicians. While they’ll gladly share their numbers, they might not be aware that they’re being paid 20% to 25% less than their male counterparts.

Already, a female physician using those numbers as her “north star” is starting out 20-25% below what her salary should be and could be. Lower salaries become a self-fulfilling prophecy when members of an underpaid demographic rely on data from their peers.

A better approach is to get data from a trusted source like Doximity, Merritt Hawkins or AMGA to hone in on the salary for a specific specialty in a specific region. Gender shouldn’t play into it. Whatever the numbers in the survey are, that’s what physicians should be targeting in their contract discussions.

With that data in hand and in mind, female physicians should seek out competing offers from other institutions in the area, to provide leverage in their salary negotiations. More important, they must be prepared to consider alternatives if their employer can’t provide an employment package that is within an appropriate range. Sometimes you have to go to grow.

This isn’t just advice that works “in theory.” It works in real life. I know because I just helped a female physician—a general surgeon in the Southeast—to get a $50,000 raise in her base salary by following this playbook.

The lesson? Women can make a dent in the pay inequity, but only if they’re proactive about taking destiny into their own hands. Because the powers-that-be in healthcare systems are just fine with paying good female doctors 75 to 80 cents on the dollar for the exact same work their male counterparts are doing.

It all comes back to the incentive structure that’s in place for those who are in power. Female doctors have been chronically underpaid for decades, but there’s no incentive for the gatekeepers of the healthcare system to change anything because it's not necessarily in their financial best interest.

If hospitals were to look at their physician compensation, line by line, and notice a disparity between males and females, why would they fix it, aside from the fact that it’s the right thing to do? The answer is, they wouldn’t. They haven’t and they won’t.

To get the compensation they deserve, female physicians can’t rely on the good intentions of the healthcare system. It’s time for them to act and claim what is rightfully theirs.

Ethan Nkana is Principal of RMPA (Rocky Mountain Physician Agency), which specializes in negotiating physician contracts.