How to Close the Gender Pay Gap in US Medicine

Indefensible differences in salary between women and men persist in medicine.

One national study of academic physicians in 24 public medical schools found that female physicians make about 10% less than their male counterparts at all academic ranks. Medscape’s 2019 Physician Compensation Report finds male primary-care and specialist doctors earning 25% and 33% more, respectively, than their female counterparts.

These differences are especially disappointing given that female physicians actually outperform male physicians in some areas; one study of 1.5 million Medicare hospitalizations found that female doctors’ patients had significantly lower mortality and fewer rehospitalizations.

The solutions for closing this gap are complex but achievable. Drawing on existing research, lessons from other fields and our own experience as researchers and leaders committed to gender equity, we believe that organizations should pursue three approaches to address the problem:

ENHANCE SALARY DATA: Lack of accurate salary data creates a major barrier both to leaders seeking to address inequities and to female physicians as they negotiate. Pay audits and increased transparency could help. Organizations outside medicine have effectively used audits to reveal pay discrepancies and enhance pay equity. Data from the Harvard Kennedy School shows that women negotiate for lower compensation than men do in the absence of clear industry standards but negotiate for equal salaries when standard salary information was available.

ENGAGE ALLIES IN COACHING AND SPONSORSHIP: Much of coaching and peer support for women physicians has focused on same-gender mentorship and peer groups. While these provide female physicians with role models similar to themselves and create comfortable spaces for reflection, given evidence that men are more likely to get explicit information about paths to advancement in management or to receive mentorship or sponsorship at all, they should be engaged as allies in systematic ways. Studies in other industries show that male sponsorship is crucial to closing the gender pay gap.

FACILITATE EQUITABLE PROMOTION: A small proportion of full medical professors across the U.S. are female, despite increased representation of female physicians on faculty and among medical school graduates. New approaches are needed to ensure promotion of women in academic medicine. These may include:

1. Revamping promotion guidelines to create tracks that reward activities aside from grant-funded research, such as teaching, that are often not rewarded in traditional promotions but are central to academic medicine.

2. Requiring that female physicians be included on all search and promotion committees.

3. Ensuring that open leadership positions are widely publicized rather than privately directed to a select group of candidates.

4. Providing grants to support women’s career advancement, including family travel grants that facilitate women’s attendance at conferences with children and child care providers.

5. Providing one-on-one external coaching to help female physicians create career road maps, tailor their resume for promotions and identify what they need to accomplish to be ready for the next step in promotions.

The initiatives we propose are just a start in solving a complex and persistent problem. It’s high time that health care aggressively engage in and rigorously evaluate efforts to close the unjustifiable pay gap in medicine.

Copyright 2019 Harvard Business School Publishing Corp. Distributed by The New York Times Syndicate.