Practice composition and sex differences in physician income: observational study

Area of Science:

• Medical Economics
• Health Services Research
• Physician Workforce Studies

Background:

• Gender pay gaps persist in medicine, influenced by various factors.
• Understanding how practice environment characteristics, such as sex composition, affect these disparities is crucial.

Purpose of the Study:

• To investigate whether the income difference between male and female physicians varies based on the proportion of male physicians within their practice.

Main Methods:

• A retrospective observational study utilizing US national physician salary data from 2014-2018.
• Analysis included 18,802 physicians across 9,848 group practices, categorized by the percentage of male physicians.
• Multivariable adjustments were made for specialty, experience, workload, and practice characteristics.

Main Results:

• For non-surgical specialists, the adjusted income gap was significantly larger in practices with >90% male physicians ($91,669) compared to those with ≤50% male physicians ($36,604).
• Similar trends were observed in surgical specialists, with greater income disparities in male-dominated practices.
• No significant relationship between practice sex composition and income disparity was found among primary care physicians.

Conclusions:

• Gender-based income differences among specialists are significantly associated with the proportion of male physicians in a practice.
• These disparities are most pronounced in practices with a high percentage of male physicians, even after accounting for other potential explanatory factors.