Last Tuesday evening after dinner, with a cup of tea in hand, I read a newspaper column titled, “Women still earn a lot less than men.” This prompted me to ask my wife, “Do you think this is really true?” Then, I editorialized, “But it can’t be true in health care.”
As I read and extensively researched the topic, my first impression could not have been further from the truth: Health professionals have among the highest levels of income disparities by gender.
A September 2013 study published in the Journal of the American Medical Association Internal Medicine found that male physicians earned 25 percent more than female physicians. “But this is understandable,” I told my wife. “More women choose specialties such as pediatrics and primary care which are significantly lower paying than subspecialists such as orthopedics or cardiac surgery, which are more often chosen by men. We are comparing apples to oranges here.”
Then I reasoned that if we adjusted for specialty and even experience, then incomes would equalize.
Anupam Jena, a professor at Harvard Medical School, commented that “among physician researchers, when you look at those who have the same number of publications, the same levels of NIH (National Institute of Health) funding, the same tenure status, females earn significantly less than males.”
One study from 2011 in the journal Health Affairs found that newly trained male doctors in New York state earned $16,819 more than female doctors. This is after adjusting for factors such as specialty choices, practice setting, working hours and other characteristics.
What about nurses, I wondered. Surely, since nursing traditionally has been a female profession, there should be no gender gap, or, if anything, female nurses should have higher incomes.
One study done by researchers at University of California, San Francisco, found that male nurses made $5,100 more than female registered nurses in similar areas of specialty and position.
So why does this happen, when women doctors are as good as men in providing quality care? Some studies have even shown that women doctors perform better than their male counterparts on a set of quality measures.
This would not have been an issue in our home, except for the fact that my wife is also a physician, like me. More so, we would not have even questioned inequality in incomes based on gender unless we had researched the data.
One fact is this: Income disparity in health care mirrors the income disparity among the society in general. In 1963, a women working full time made 59 cents for each dollar compared to a male colleague in the same position. Now it is 82.5 cents. This means that a woman works Jan. 1 to March 3 effectively without any pay compared to a male colleague. “The gender gap in earning exists even among lawyers,” I told my daughter, who is a first-year law student.
Some have argued the pay difference is justified because men are more productive than women in the field of health care; the male doctors see more patients over a period of time and bring in greater collections. The evidence from scientific studies is not clear on this point.
“So why is that?” my wife asked. “Why do women earn less than men?”
Part of the reason can be that women are more likely to interrupt their careers to care for family, and they may prioritize other things such as lifestyle, flexible hours and more time off rather than a higher income. Also, women may not negotiate for a higher salary. But part of it has to do with our past.
Inequality is so subtle and so ingrained in our day-to-day lives and in our culture that we don’t even notice it unless someone points it out. At first, we don’t make an effort to look at the data; then we ignore it, then dismiss it; then we want to refute it, and then we say “such is life” and move on. It takes courage to confront inequality and try to mend our ways.
Last Tuesday, one day before income-tax day, also happened to be Equal Pay Day, organized by a women’s coalition to bring attention to the issue. They certainly caught my and my wife’s attention.
Source : Commercial Appeal