Women teaching internal medicine paid far less than men, study finds - Healthcare Dive

Dive Brief:

• Women who teach internal medicine specialties are paid significantly less and have lower representation in leadership positions than their male counterparts, according to a new study published in JAMA Internal Medicine
• The study, released Monday, analyzed 154 U.S. medical schools between 2018 and 2019. Researchers found women were paid at least 90% of men's median yearly salary in 10 of 13 internal medicine specialties, but didn't reach that threshold in cardiology, gastroenterology and critical/intensive care. And when examined by rank, men's salaries still exceed women's in 56 of 62 categories.
• Women also made up fewer than half of total full-time faculty across all ranks, researchers found. Representation between the genders was almost equal at the instructor and assistant levels, but female representation dropped to just 24% in higher posts like professor and chief.

Dive Insight:

The percentage of women in full-time academic positions has steadily increased since 2009, according to the Association of American Medical Colleges. Now, women make up roughly 41% of teaching positions.

But pay and representation disparities have persisted, mirroring a larger problem in the medical profession (and overall U.S. workforce) as a whole.

The latest study found women made up the majority of faculty in three specialties: general internal medicine, endocrinology and geriatrics; while procedural specialties — pulmonology, critical/intensive care, gastroenterology and cardiology — had the fewest female faculty. The disparity was most acute in cardiology, where women make up just 21% of the workforce.

Women's median annual salary in all faculty positions was about $25,000 lower than men's in all ranks except for chief, where the disparity was larger, researchers found.

The three specialties in which women's median salary did not reach 90% of men's — cardiology, gastroenterology and critical/intensive care — paid out higher salaries overall, but also had the biggest gender disparities in both representation and salary, particularly in higher ranked positions.

That finding aligns with past research suggesting the biggest differences in salary exist in practices and specialties with the highest proportion of male physicians, the study said.

"The reasons for this remain unclear," researchers wrote. "IM procedural specialties have long been male dominated in composition and leadership, despite increasing gender parity in the preceding training stages ... These findings emphasize the importance of gender diversity to achieving salary parity in IM subspecialties."

Though disheartening, the data is not surprising given historical disparities in healthcare.

Data from 2019 suggested the physician pay gap was narrowing slightly. However, a 2020 survey from clinician network Doximity found the compensation gap was actually growing, with female doctors earning 28% less than their male counterparts, up from 25.2% in 2019.

And despite the fact that women make 80% of buying and usage decisions in healthcare, they're largely absent in industry C-suites, making up roughly 30% of senior leadership positions and just 13% of CEOs, according to Oliver Wyman.

However, though representation at the highest echelons is still lacking, healthcare is a friendlier industry for women than other sectors, research suggests. According to McKinsey, women in healthcare are better represented at all levels than in other industries, are promoted at similar rates as men and report high career satisfaction.

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