By Sharmistha Dev
In recent years there has been a burgeoning number of females entering the medical profession. Approximately one fourth of the medical field today consists of female doctors, an increase from the 7.6% in 1970 . Currently, 45% of all medical students are female . However, an income gap still remains between male and female doctors. In fact, in a study conducted by the Women’s Physicians Congress in 1997, the average salary for female doctors was estimated as $120,000, which is 31.4% less than the $175,000 average for male doctors . This disparity has not narrowed much since 1982, when the income gap was 35.3% . The practice of medicine must be analyzed in order to determine the causes of this alarming inequality.
Some may argue that the inequality of income results from the different specializations of male and female doctors. It is widely agreed that males are more inclined to work in high-risk specialties such as surgery. Women are more predisposed to people-oriented specialties, as indicated by The Journal of the American Medical Women’s Association (JAMWA) in 1997, which reports that “two-thirds of residents specializing in pediatrics and gynecology are females,” while only 1 in 5 of the residents in surgery are female .
This report also suggests that the reason for this phenomenon may be that many women want to have families, and more demanding specialties might hamper them from doing so . Therefore, the income of males will be disproportionately higher, because specialists tend to earn more money than primary care physicians. However, it has been found that “women’s median income was 27% less than men’s in family practice, 29% less in internal medicine, and 34% less in pediatrics in 1991" . This reveals that even within specialties that are considered to be female dominated, males tend to earn more.
Another reason contributing to the disparity may be the differences in workload of male and female physicians. Because female doctors generally have greater household responsibilities, they are known to see a fewer number of patients per week and work fewer hours than male doctors. The average number of patients that a female doctor sees in a week is 100.5, while that of a male doctor is 120.9. Moreover, the average hours worked per week by women doctors is 54.3 hours, while that of their male counterparts is 59.8 hours . Hence, income discrepancies may be due to decreased work hours of female doctors.
Another factor contributing to disparity is that female doctors may have a greater inclination to not be self-employed. This is because many female physicians believe that hospitals offer greater job security and recognize that, at a hospital, there is no need to be on call 24 hours a day. This would allow women to pay more attention to their families. According to the Standard Times, a greater proportion of female doctors are employees while 3 out of 5 males are self-employed . Again, family concerns may be the reason for this incongruity since hospital jobs offer more stability.
The greatest discrepancy occurs with regard to academic medical positions. Although a greater fraction of women than men decide to pursue the academic medical field, academic medicine is still dominated by men. In fact, while 31.5% of male professors were at the full professor position in 1991, only 9.6% of female professors attained this recognition . Since full professors are known to have a greater salary than assistant professors, this situation widens the gap between the incomes of male and female doctors.
The most widely drawn on case used to describe the inequity of incomes is that pregnancy and family responsibilities are of greater significance to female physicians. For females in many professions, having a child is still correlated with a lack of seriousness and commitment. Consequently, females make up the second tier of incomes . In the academic line, women who decide to spend more time with their families may lose their tenure since this would prevent them from publishing as many papers. Also, many hospitals still have inflexible policies regarding pregnancy, such as unpaid leave after the birth of a child . Even in residencies, a pregnant woman may experience resentment from other residents who feel that they must unfairly compensate for maternity leaves . These attitudes towards women prevent them from advancing within the medical field and hence from gaining an equitable pay.
As evidenced, the lack of salary equity between male and female doctors is due to the fact that not many females occupy the highest positions available within the medical profession. It cannot be argued that male doctors are more capable since men and women perform at the same level in medical school .
This inequality might be rectified by adjusting the compensation given to female physicians so that they are given the same pay for doing the same work. Also, medical institutions should appropriately implement the parental leave requirements, as stated in the Family and Medical Leave Act of 1993 . This means that there should be greater ease for physicians to reenter the work force after taking pregnancy leave or time away from their careers in order to start a family.
In academia, the publishing requirement should take into account pregnancy and family leave. Also, tenure positions should take into consideration teaching skills instead of overvaluing research. The lack of tenure positions for females means that many “women’s issues” such as ovarian cancer are not being given the attention they deserve. The failure to give females more permanent positions means that such issues may be disregarded. Medical schools should also offer more leadership positions to women, not only by giving them greater accessibility to these positions, but also by providing future female doctors with role models or mentors. These leadership positions can easily be filled since there is a large pool of qualified female candidates. All of these methods will help to raise the overall income of female physicians.
Female physicians are starting to make some progress in bridging the gap between men and women in medicine. As stated before, an ever-increasing number of females are entering medical school. Moreover, women have built a better reputation as physicians in primary care specialties. In fact, some patients of primary care facilities prefer female doctors, claiming that female doctors are more attentive to their patients and can relate to them more . That may be a reason why female doctors see fewer patients than male doctors . Also, journals and associations such as the American Medical Women’s Association have aided to publicize the role of women and their contributions to the medical field.
However, this progress is miniscule in comparison with the problem at hand. More attention must be given to this matter, since income disparities between men and women reverberate throughout all professions, not just medicine. If society is founded upon fairness and equity, then the incomes of female professionals ought to match incomes of similar male professionals.