Large gap remains between male, female physician pay

Male physicians earn an average of $1.25 for every $1 female doctors make, but the wage gap slightly narrowed for the first time in three years, according to a new report.

The wage gap fell nearly 14% in 2018 as female doctors earned $90,490 less than the average male doctor in 2018, down from $105,000 in 2017, according to Doximity's analysis of 90,000 U.S. doctors, representing the largest repository of physician compensation data. Male wages stagnated in 2018 while female compensation grew by 2%.

But significant disparities still exist in individual markets. The wage gap is just 9%, or $28,681, in some smaller cities like Birmingham, Ala. That compares to 2017's smallest wage gap of 20%, or $73,654. But female physicians from Louisville, Ky., to Hartford, Conn., make up to 40% less than their male peers, Doximity's data show.

This data would've been helpful when Dr. Mandy Huggins Armitage was negotiating her salary, she said.

"It is going to take time to right itself. But the good news is that we are having this conversation now," said Huggins Armitage, Doximity's director of medical content. "I am hopeful this will continue to improve. If we continue to empower physicians with data, we can let them make their own conclusions and advocate for themselves."

Nearly two-thirds of the 50 metro areas studied saw the wage gap decrease in 2018. While it's better to be a female doctor in Milwaukee than in any of the other 50 metro areas, she still earns on average $62,523 less than a male physician in the highest-paid metro area for men, New Orleans.

Metro areas with lower average compensation tend to house more academic institutions, which maintain a competitive pipeline of well-qualified doctors.

Overall, physician compensation has begun to plateau, which is also a new trend, according to Doximity. This may be due to provider consolidation, which can stymie wage growth as hospitals aim to cut costs to focus on efficiency, researchers said.

"The healthcare landscape is changing quite a bit," said Chris Whaley, lead author of the report and adjunct assistant professor at the University of California, Berkeley School of Public Health. "The small, independent practices aren't around as much anymore as many physicians now work for large specialty practices, hospitals or health systems."

Annual salaries for health system-employed doctors, which continue to grow in number, remained around $342,000 from 2017 to 2018, Doximity found. Hospital-employed physicians' average salaries fell by 1% while doctors at academic institutions earned 9% less year over year and had some of lowest salaries comparatively.

Doctors in single-specialty groups, multispecialty groups and solo practitioners, who generally earn more than their hospital- and health system-employed counterparts, saw their salaries increase between 1% and 3% from 2017 to 2018.

Notably, only 14% of private practices are owned by female physicians. Women are also still a rarity in high-paying surgical specialties, related research shows.

"But the physician workforce, which traditionally has been predominantly male, is becoming much more equal," Whaley said. "Last year, for the first time, more females than males graduated medical school."

More money seems to be flowing to administrators than physicians as health systems consolidate. Health system administrators took home raises of 6% to 8% over three of the past four years, up from around 2% in 2014, according to Modern Healthcare's analysis of executive compensation data.

"We know that these big health systems are able to charge higher rates to insurers, and it looks like a big portion of the price increases are going to the hospital system and not the actual doctors," Whaley said.

Wage disparity is one of the issues that the recently launched Time's Up Healthcare aims to address, which was spawned out of the #MeToo movement.