The 2018 Doximity Physician Compensation Survey just landed and my head is swirling with thoughts. There are so many interesting trends to highlight: the gender pay gap; the pay gap between Primary Care and subspecialists; the huge gap between the proceduralists and the generalists; and the relatively low pay for all pediatric doctors. However, I’d like to focus on the narrowing pay gap for women in medicine, which for me, offered a glimmer of hope.
The past few years of physician compensation surveys administered by Doximity demonstrate a consistent pay gap of about $100,000 between male and female physicians. Why is this? While many people chalk it up to the larger number of women working part-time, the Doximity survey only included full-time workers of at least 40 hours weekly. It seems that the gap starts right out of residency, as demonstrated by the Center for Health Workforce Studies at SUNY Albany showing male physicians fresh out of training in 2016 had a starting salary that was $26,367 more than their female counterparts.
In the 2018 Doximity Physician Compensation Survey, the reported gender pay gap finally dropped below six figures. The gap in 2018 was $105,000 and now it has fallen to $90,490. This varied based on the metropolitan region. For example, Birmingham had the lowest gender pay gap, where local male physicians were paid $28,542 more than their female colleagues. By contrast, Louisville-Jefferson County has a gap of $154,077 with female physicians earning 40 percent less than their male colleagues.
The enormous gender pay gap in medicine is difficult for some to wrap their heads around, especially teachers, civil servants, and government employees where pay is simply based on years of experience or your “step” in the pay scale. But really, is the persistence of the gender pay gap so surprising in a world where until recently the White House didn’t have lactation rooms and NASA just canceled the first all-female spacewalk due to a lack of appropriately sized space suits?
It is deplorable that in America in 2018 the most highly trained and highly educated profession pays men $1.25 for every dollar women make. The existence and persistence of the gender pay gap is medicine’s dirty little secret. However, just like shame researcher Brene Brown discussed in her excellent book titled Daring Greatly, there’s something really powerful when you speak about shameful things. Perhaps it is the public airing and discussion of the pay gap in the past few years that lead to this change.
While the gap is still significant and unfathomable, I am choosing to view this in a positive light, as a signal of progress. We are still in a man’s world, but this survey tells me that times are changing.
Last year brought us memorable moments like the comments of a male internist in the Dallas Medical Journal who confidently hypothesized that “female physicians do not work as hard” to explain the pay gap. This was quickly followed by expert interviews with the formidable Drs. Esther Choo, Jane Van Dis, and Dara Kass with national media outlets fighting his overtly sexist and biased comments with scientific evidence to the contrary.
In addition, in 2018, we continued to see large organizations of women within medicine putting on conferences — from FemInEM to American Medical Women’s Association to Brave Enough and Girl Med Media conferences, not to mention all the grassroots organizations that provide a unified voice for women in medicine on an institutional and local level. Even if the drop in the gender pay gap was a fluke, 2018 showed me that this issue is finally on people’s radar. For the first time in many years, we are seeing progress and this leads to hope.
Women in medicine: let’s own this success. We can use this small piece of progress as fuel to work further to end the disparity. Why not take this decrease in the pay gap of $10,000 and make banners out of it, like our very own suffragette sashes? Or, can the $10,000 inspire a graphic that we can add as our Twitter backgrounds and a call for more change in 2019? Or can it be an affirmation of the impact we are making on a grassroots and national level on a daily basis is worth it?
Instead of hanging our heads at the still gigantic gender pay gap, let this become our rallying cry to go after what we deserve: equal pay for equal work. Women in medicine, let’s work together on all levels to go after our next $10,000. The work we do is worth more than one dollar for every $1.25.
Dr. Lauren Kuwik is a Medicine/Pediatrics physician as well as a 2018–19 Doximity Author.