Women physicians face barriers common to the “New Breadwinners” in A Woman’s Nation. Women are moving into the physician labor force in record numbers. More than half of the 2009 class entering medical school consisted of women. In 2008 nearly 30 percent of all practicing physicians in the United States were women, according to the American Association of Medical Colleges. While this does not approach the 50 percent employment rate of our sisters in other segments of the labor force, this trend is quite stunning given the entrenched bias against women in the venerable but highly inflexible “house of medicine.”
Most important to this trend is that the work patterns and experiences of this particular group of women workers have far-reaching effects on the health and well being of our entire society. Physicians have the responsibility of providing us with a healthy workforce, both present and future. We can’t afford to have women physicians denied the opportunities and resources to reach their potential and contribute accordingly. Understanding their needs and eliminating the effects of sexism and gender discrimination goes well beyond the individual and her family. The continuing gender gap in salary and professional advancement that negatively impacts female physicians deeply affects the health and prosperity of our nation.
While many women are forced to work for economic reasons, women physicians do not enter this long, difficult, and protracted career path solely for economic incentives. Medical student indebtedness averages $100,000 for public and $135,000 for private medical schools. Compounded by three to seven years of postgraduate training at an hourly rate that is far below their level of education and responsibilities, this debt is enormous. Try to simultaneously work 80-plus hour work weeks (if one includes the studying and reading required when “off duty”), repay the loans, begin a family, or purchase a home on a resident trainee’s salary! Entering the physician labor force at the earliest age of 29 years—though most enter in their early to mid-30s—places all physicians at a distinct disadvantage, monetarily speaking.
But it is much worse for women physicians. Women physicians, from the outset, are paid less than their male counterparts for the same work. The U.S. Census Bureau reports that the women physicians earn 63 cents on every dollar that men physicians earn. And according to the same report, “No other profession in the United States exhibits greater salary disparities by sex.”
But even accounting for numbers of patients seen and hours worked, women physicians receive less compensation. (Myth: The majority of women doctors work part time. Reality: 70 percent have always worked full time, and the remaining 30 percent have worked part time for an average of 8.3 years. ) Take shift work in the emergency department or, more persuasively, the emerging specialty of hospital medicine.
Despite similar work schedules, commitment, education, duties, and the absence of “seniority” issues and the old boys’ club, women hospitalists are compensated significantly less than their male colleagues. Why? Because hospital administrators know they can get away with it, and women physicians are still unprepared to demand their equal share.
No question that women are segregated (the current sociological term is “ghettoized”) into less remunerative, less prestigious medical careers: pediatrics, obstetrics/gynecology, psychiatry, family practice, and internal medicine. The reasons for this segregation are many, ranging from subtle (or not-so-subtle) discouragement from medical school advisers to negative personal experiences during rotations in the higher-paying, male-dominated specialties. The feminization of a medical specialty often relegates its practitioners and thus the specialty to a lower status. Almost all of these less-favored specialties have a greater impact on women—the healthcare of our children, mental health, and women’s health. No big surprise there.
Thus, the reality of the new women physician breadwinners in healthcare is not a pretty picture. How to reach our ideal? Next post, next week.
This post was written by Linda Brodsky, pediatric otolaryngologist and advocate for gender and pay equity. Her blogs can also be read at The Brodsky Blog.
