Opinion

Let’s narrow the pay gap: Female doctors may have better patient outcomes

Studies find that patients treated by women doctors may have better outcomes, yet female physicians are still getting paid less.

Editor’s note: This is an opinion piece; the views expressed are the author’s own and do not necessarily represent the views of The DO or the AOA.

A recent controversial study in JAMA Internal Medicine examined hospital mortality and re-admission rates for Medicare patients treated by male vs. female physicians. The study examined more than 58,000 DO and MD internists’ handling of 1.5 million Medicare patient admissions.

After adjusting for confounding variables such as patient age and coexisting conditions and physician youth, training and experience, the study found that elderly hospitalized patients treated by female doctors have significantly lower mortality and re-admission rates than those cared for by male physicians in the same hospital setting. These findings appear to validate earlier studies, including those in the European Journal of Heart Failure and the Journal of Internal Medicine, that produced similar results.

The study’s authors propose some possible reasons for women physicians’ improved outcomes, including greater reliance on clinical guidelines of evidence-based medicine and practice patterns more focused on patient-centered care. As medicine becomes increasingly focused on pay-for-performance, these types of behaviors that lead to improved outcomes should be rewarded, which may in turn help narrow the pay gap between the sexes. Pay and gender equity will lead to better professional fulfillment, incentivize women to maintain or advance their medical careers, and help provide better health outcomes for the patient—a goal to which we all aspire.

Coverage of this study in Medscape generated over 130 lively, wide-ranging comments that are worth reading.

Pay gap persists

A related editorial in the same issue of JAMA Internal Medicine as the study noted previous research showing that female physicians in academia were less likely than their male counterparts to have reached the rank of full professor (11.9% vs. 28.6%), obtain adequate start-up funding for research projects that help launch faculty careers (67.5% more money for men than women), and be paid equal salaries for the same academic job (8% less for women=nearly $20,000/year difference).

Myriad rationalizations for these disparities have been proposed, the editorial noted: things like the burden of home responsibilities, child-bearing and rearing duties, or part-time schedules affecting female doctors’ quality of work. However, these arguments have been largely disproved by other studies, including the study this article focuses on.

DO observation

Another interesting observation worth noting; the female doctors in the study were more likely to be DOs: 8.4% of the women doctors in the study were DOs while only 7% of the male physicians were DOs. One has to wonder if future studies will find that DOs’ hands-on holistic approach is also associated with better patient outcomes.

At the least, further investigation is certainly warranted.

    12 comments

    1. Great article, thank you. I’m sad to see the editor felt the need to say the AOA doesn’t hold the same views. 90% of our issues as women and as DOs are institutional, which the AOA should be working hard to eliminate, not brushing under the rug.

    2. You have to also take into consideration a few other things.
      1. Most female doctors reduce their patient and work load once they have children. This allows them to focus on a smaller core of patients.

      2. Male doctors tend to work 60-70 hours a week. This most likely drops the amount of time they actually spend with a patient and effects how the treat their patients.

      1. Come on Charla, you can’t possibly be serious?? You are using reason and logic to account for the difference. These facts are exclusively prohibited from this argument!!!!

        1. Charla’s comments are reality in the world of medicine. Not sure if you, anonymous student have actually practiced medicine and actually submitted billing for payment.

    3. I know this might not be politically correct but certainly when you bill and insurance company with a code just because you’re a woman who supposedly has better outcomes won’t give you any more money. Osteopaths as founded by Dr. still are all equal remember blacks in the first class women in the first class no discrimination with color creed or whatever. Whining about money isn’t becoming to an osteopath we are all brothers and equal OK sisters.work and pray with diet exercise and clean air in the world is yours

    4. This is a load of garbage. There is likely a variable to account for this difference. A study suggesting males provide better care would never be published because it is not politically correct. Also, females earn less because they see less patients on average due to working part time and leave for having children. If the osteopathic associations (like the AOA) continue to push this liberal politically correct BS agenda I will ensure that I do not support them.

    5. This shouldn’t come as a surprise, Dr. Merritt’s perspective is liberal. From her twitter account “@WhiteHouse Time to solve the climate crisis. Let’s strengthen our commitment to the Paris Agreement. #RoadForward.” Just to be clear, there is no “climate crisis.” Although largely ignored by the MSM, the evidence presented around the time of the Paris agreement was based on carefully selected data (i.e. data convenient to support the hypothesis in an attempt to get more grant money). Scientists who don’t publish results consistent with this liberal talking point are no longer given grants. The type of science supporting global warming would be dissected and discredited if it were involving a pharmaceutical company attempting to get a new drug approved. Could we get some opinion pieces from a non-left leaning perspective?

    6. Wow. So I suppose all of you deny that women are paid less than men, and people of color are paid less than white people. I’m sure you’ll also deny that there is institutional sexism and racism in medicine as well as in the infrastructure of our entire country. But those things are proven. The pay differences are literally ‘for the same job,’ so it isn’t about insurance codes or time off, or individual differences but salary disparities across the country.

      1. @Jon, my comment above was sarcastic. I absolutely believe there are facts that support a reason for the pay difference and those facts do not consist of women earning less than men for completing the same QUANTITY of work. As a medical student closer to the end of my studies than beginning, I have submitted billing for payment (although in the name of the physician I was working under). I didn’t notice anything requiring the physician’s gender that accounted for the payment of services provided. Both healthcare systems I have worked in compensate physicians based on productivity (RVUs and bonuses based on meeting certain RVU quantity). For physician’s that don’t want to work as much (regardless of gender, race, or reason), their compensation is less due to less productivity (nothing to do with gender). If this so called “gender salary discrepancy” was real, their would be an abundance of real world examples to support it. Instead, we are expected just to believe vaguely that there is a difference and not question it. No one can say, healthcare provider XYZ pays it’s women physicians on average $22,000 less than the men providers. If such a statistic existed, it would likely be misleading because the difference could be accounted for based on specialty, hours worked, or numerous other non-sexist reasons.

        1. A.S-

          I agree with you. The insurance company does not know if the physician is male or female.

          In the academic world, the total compensation is based upon many factors. In the private world, it is either wRVU’s or based upon collections. Either way, in those cases, the insurance company, Medicare, Medicaid or self pay doesn’t care what your gender is.

          This article is simply trying to play to the liberal flavor of the day.

    7. I haven’t really encountered pay differences in my experience so far. First, everyone knows that all physicians-in-training who are at the same level are given exactly the same salary and benefits offered by their institution. Doesn’t matter how hard they work, how many patients they help, or what their sex or race is.

      With regard to attending salaries, I will say that I recently signed with a company for my first job as an attending. This is a large organization which has a set way of paying their physicians. Although I am a white male from the USA with a solid CV, I was not able to negotiate a higher salary. They offered me what they offer everyone, and that’s what I accepted. Now, ultimately my pay will depend on how many patients I see, because it is RVU-based. This time, it will matter how hard I work and how many patients I help. There are even incentives built into the pay for having good outcomes. But nothing in the salary is dependent on one’s sex or race. There is simply no conceivable way that it can play a role.

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