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Report: The Primary Care Gender Pay Gap Is Growing

Differences persist despite evidence that women internists reduce mortality and recidivism in hospitals.
Courtesy: iStock

The gap between what male and female physicians make is larger now than it was 10 years ago, according to the 2022 Physician Compensation Report from Medscape.

In primary care, women physicians make $228,000 while men earn $285,000. In 2012, Medscape’s survey found that men made 23 percent more for primary care. This year, that gap has increased to 25 percent. The poll asked more than 13,000 physicians in more than 29 specialties to take a ten-minute survey and answer questions about their practice and pay scale.

It isn’t all bad news for women, though. The gender pay gap is shrinking for specialty physicians, though still larger than the primary care gap. In 2022, the gap between specialists was 31 percent, with women making $307,000 per year and men making $402,000. In 2017, the gap between men and women specialists was 37 percent. More women are entering higher-paying specialties, though they are still overwhelmingly male. Women made up just 5 percent of orthopedic surgeons in 2015, but women made up 14 percent of orthopedic residents. Women make up less than 20 percent of all surgeons in plastic surgery, another high-paying specialty, but their numbers are growing.

These salary gaps remain but could be in for significant changes. Women now make up 60 percent of all students enrolled in college and represent 53.7 percent of medical school graduates, according to the American Association of Medical Colleges. For the past four years, women have been the majority of medical school matriculants. But women are less likely to advance in their careers and be faculty members. Women make up 41 percent of all medical faculty and just 18 percent of department chairs, according to a 2018-2019 report from AAMC.

In 2018, men were still the majority of residents at 54 percent, and women are still more likely to pursue the lower-paid specialties. Women made up the majority of residents in pediatrics, family medicine, psychiatry, immunology, and neurology, which are all on the lower end of the pay scale (less than $330,000 per year).

While much of the salary gaps are due to the patriarchal history of medicine, meaning elderly white men occupy many senior positions (and the larger paychecks that go with them), there is evidence that women may be getting better outcomes, at least in internal medicine. A 2017JAMA Internal Medicine paper found that women physicians had “significantly lower mortality rates and readmission rates” with Medicare patients compared to male physicians at the same hospitals. The study found that women were more likely to adhere to clinical standards and evidence-based practice, though it said it is largely unknown whether patient outcomes differ between men and women.

Past studies have shown that women are more likely to provide preventative care, use patient-centered communication, perform as well or better on standardized exams, and provide more psychosocial counseling to their patients than their male peers.

But some of the lower-paying specialties are getting larger salary bumps, especially as many payers are pushing for more preventative care to reduce downstream costs, which is usually done in a primary care setting. Pediatrics (10 percent), immunology (9 percent), family medicine (8 percent), and OB/GYN (8 percent) were all among the specialties with the largest salary increases over the past year.

These specialties lag far behind when it comes to bonuses, though. The average orthopedic surgeon gets a $126,000 bonus each year, while pediatrics, family medicine, OB/GYN, and psychiatrists all get a bonus of less than $50,000 on average.

As more women have been able to break down barriers into specialties where they have not been present before, aspiring female medical students, residents, and fellows now have opportunities for more female mentors in the field of interest,” says Ron Holder, chief operating officer of Medical Group Management Association told Medscape. “The benefit of that in recruiting women to the specialty can’t be overstated.”

Check out the survey here.

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