(Reuters Health) - Although salaries for U.S. physicians edged higher in 2018, gaps in compensation remained unchanged for females and African Americans, according to Medscape’s latest Physician Compensation Report, online April 11.
“The gender gap, notably among specialists, remained unchanged, with men earning about 36 percent more than women specialists,” Leslie Kane, Senior Director, Medscape Business of Medicine and author of the report, told Reuters Health. “It’s quite possible that bias was one of the contributing factors.”
“But in addition,” she said by email, “most of the specialties that women choose - with the exception of plastic surgery - are among the lower-paying ones, such as obstetrics/gynecology, pediatrics, public health and preventive medicine, and family medicine.”
“Specialties with the lowest percentage of women are orthopedics, cardiology, gastroenterology, otolaryngology, and radiology, which are higher paying,” she said.
Overall, physician salaries average $299,999 in the 2018 report, up from $294,000 in 2017. Specialists earn about $100,000 more than primary care physicians ($329,000 versus $223,000), and plastic surgeons ranked highest at $501,000.
“While plastic surgeons have always been among the top in compensation, the impact of a greater acceptance for cosmetic procedures helped propel that specialty to the top of the list for the first time,” Kane said.
Also notable, compensation rose by 16 percent for psychiatrists, for whom “the impact of supply and demand was stronger than expected,” Kane stated.
“The need for mental health services increased both from the opioid epidemic and issues such as dementia in the aging population, and the number of psychiatrists has not kept pace,” she said.
Pediatricians and family practice physicians reported the lowest compensation, at $212,000 and $219,000 respectively.
But disparities are clear. Male primary care doctors earned almost 18% more than their female counterparts, and men in specialties earned 36 percent more than women this year, versus 31 percent in 2017.
Specifically, male primary care physicians’ compensation averaged $239,000 versus $203,000 for women, and males in specialties earned an average $358,000 versus $263,000 for women.
Overall, African-American physicians earned an average of $50,000 less per year than white physicians ($308,000 for white physicians versus $258,000 for black physicians).
African-American women made nearly $100,000 less than male African-American physicians ($322,000 for men versus $225,000 for African American/black women).
What can be done to bridge disparities?
“Awareness and transparency can begin to make a difference,” Kane said. “Our physician experts have told us that women in medicine often have no idea what their male colleagues make.”
“As in many professions,” she said, “salary is simply never discussed, so women don’t know that they are being paid less. Discussion between colleagues and recognition can spark change, which we’ve seen with other industries.”
"This is not a U.S.-only issue," Kane observed. "A new Medscape report on UK physician salaries (wb.md/2IIIvio) found a 56 percent gap in pay between male and female physicians in the National Health Service."
“Our (gap) was higher than was found in the NHS’ own report, but even there, the difference was significant,” she said. “As in the U.S., the issue is multifactorial, but bias is a potential contributing factor.”
Dr. Cynthia Gyamfi-Bannerman, Co-Director, CUMC Preterm Birth Prevention Center in New York City, was not surprised by the survey findings.
“As a woman and a minority, I’m acutely aware of these issues, and women in medicine in general are also aware,” she told Reuters Health by email.
“Studies like this one that point out the existing disparities are an important first step towards the solution,” she noted. “I am fortunate to work in an institution with a female department chair and with many women in leadership positions. I think this is also important in driving the motivation for change.”
“As an OBGYN, a field now dominated by women, we can do more to have women in leadership roles,” she said.
Beyond the disparities findings, Medscape’s Kane noted, “The amount of time physicians are spending on paperwork and administration has become mind-boggling.”
“In total, almost three-fourths (71 percent) of physicians spend more than 10 hours per week on paperwork and administrative tasks,” she said. “In 2017, that percentage was 57 percent.”
The report is based on responses of more than 20,000 U.S. physicians across 29 specialties.