How to Narrow the Physician Gender Pay Gap

Learn what's behind pay inequity and how health systems can make a difference.


To better understand salary inequities facing women physicians, read part 1 of our series: Exploring the Physician Gender Pay Gap.

Wage inequities in medicine have always existed, but the COVID-19 pandemic has made it even harder for women to make headway in closing the physician gender pay gap. A 2022 Medscape Physician Compensation Report found that women in Primary Care earn 25% less than men. Among specialists, that pay gap widens to 31%.

Particularly during the height of COVID-19, many female physicians’ jobs and incomes were disproportionately affected. According to a 2020 JAMA study, 25% of women doctors took on greater household and parenting responsibilities compared to 1% of male doctors. To accomplish this, many women reduced their hours, lowering their income and leading to a higher burnout rate among women doctors.

6 Reasons the Gender Pay Gap Exists

Reasons behind the gender pay gap are numerous and complex. Read below to learn about some of the long-standing beliefs and biases in medicine that can stack the deck against women and perpetuate lower salaries:

1. Cultural Attitudes and Bias

Male physicians are largely viewed as primary breadwinners, especially if they have children. Doctors who are dads frequently see their wages increase – an effect dubbed the “fatherhood bonus.” However, earnings for physician moms are adversely affected – an impact termed the “motherhood penalty.”

2. Parenting and Domestic Tasks

In dual-physician households, women physicians more frequently take on the role of primary childcare provider, choosing to work fewer hours per week than their male counterparts and female doctors who don’t have children.

3. Referral Imbalance

Referrals to female physicians tend to be for lower-paying procedures, whereas men are more often given referrals for more involved, difficult procedures.

4. Lack of Leadership Opportunity

Contributions from women in leadership roles are frequently underappreciated. In addition, women are often entirely overlooked for leadership roles, as they are viewed as “already having a lot on their plates,” especially if they have children.

5. Longer Patient Visits

Women physicians typically spend more time with patients, reducing their income in a model where providers are paid per patient encounter. Because women are viewed as having a “better bedside manner,” they are often sent or given challenging patients who are more time-consuming to treat.

6. Specialty Choice

Women often choose lower-paying specialties, such as Gynecology, Pediatrics and Primary Care. Men far outnumber women in lucrative specialties like Cardiology (14% women) and General Surgery (15% women). Reasons for this point back to societal gender roles. For example, a Stanford study found that women are put off by Cardiology because of the unpredictable hours, the radiation used during procedures and the male-dominated culture.

Closing the Physician Gender Pay Gap

Closing the gender pay gap will be a lengthy and nuanced process, with the World Economic Forum estimating it will not happen for another 136 years.

Here, we’ve gathered some of today’s best practices that have shown promise in breaking down the barriers to fair compensation.

5 Ways Health Systems Can Begin to Move the Needle on Pay Inequity

1. Pay Transparency

Share benchmark compensation data with new recruits in the hiring process and use it to determine starting salary. For a fee, you can access current compensation reports from Medical Group Management Association (MGMA) for community-based practice and the Association of American Medical College (AAMC) for academic practice.

2. Centralized Referral System

Funnel all referrals through a centralized hub. This removes the opportunity for conscious or unconscious bias from physicians who have a tendency to refer patients needing higher-reimbursed procedures to male physicians. This system objectively refers patients through a rotation system.

3. Equitable Promotion Guidelines

Create promotion protocols that elevate more women physicians to higher-ranking positions. Openly publicize all leadership opportunities, adjusting promotion requirements to consider clinical and research accomplishments and providing family grant opportunities to encourage conference attendance by women.

4. Pre-defined Pay Structures

Use pay structures based on board certifications and specialty. This gender-neutral method, largely used by Providence, eliminates individual pay negotiations during the hiring process and is being considered by more and more health systems.

5. Panel and Quality Incentives

Tie some compensation to other metrics, like quality and/or panel size. This rewards a different style of practice, whereas many pay plans reward volume. Panel and quality incentives recognize work that doesn’t generate more wRVUs. It also accounts for more time spent on patient management and outcomes. Learn more from our article, “Production-Based Pay: A wRVU Primer,” which shares more about the wRVU model — based on cumulative patient encounters, and “5 Ways to Ensure You’re Getting a Fair Offer,” which explores the shift-based pay model.

What PS&D Is Doing to Help

Our PS&D recruiters are uniquely positioned to help women level the playing field. Not only can they pinpoint obstacles, but they can also help you prepare for every step of the contracting process and advocate for you at the negotiating table.

Provider Solutions & Development partners with more than 25 healthcare organizations across the country. This gives us a unique vantage point and breadth of knowledge that allows us to pass on best practices to our partners, providing consulting services as well as comprehensive, end-to-end recruitment solutions. To learn more about how we can help your healthcare organization, get in touch today. Let’s start the conversation.

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