Family Medicine's Gender Pay Gap

• Family Medicine
• Gender Differences
• Income
• Primary Health Care
• Surveys and Questionnaires
• Women Physicians
• Workforce

Despite the rise in the number of women in medicine and evidence that female physicians have better patient outcomes, women physicians continue to earn less than men.^1,2 A recent study showed that females generated lower relative value units despite spending more time in direct patient care compared with their male colleagues but did not study income.³ Studies that have focused on income have not reported data for family medicine specifically and have not accounted for hours worked.^4,5 Our objective was to examine the gender pay gap in family medicine, accounting for number of hours worked.

Self-reported clinical income and work hour data from the 2019 American Board of Family Medicine (ABFM) National Graduate Survey were analyzed. This survey, which collects demographic and practice-level information, was administered to all ABFM diplomates 3 years after residency completion and had a 73.6% response rate. Participants' free text answers to “What is your most recent pretax annual clinical income?” and “Please estimate your typical workload (hours per week)” were analyzed. The total number of weekly hours reported was multiplied by 52 to obtain annual hours worked. Hourly pay was calculated by dividing reported income by annual hours worked, and results were stratified by gender. Respondents who had missing values were dropped.

The final sample consisted of 2371 respondents, 55% (1304) of whom were female and 45% (1067) male. The average annual income for respondents was $217,018, and the average workload in a typical week was almost 54 hours. Female family physicians on average earned less and worked less than male family physicians: females' average annual clinical income was $43,098 less than males, and they worked 3.9 hours less per week. However, when examining hourly compensation, we found that this difference in earnings could not be explained by hours alone. On average, female family physicians earned $79/hour, whereas male family physicians earned $94/hour, amounting to a nearly 16% difference in hourly pay. This pattern held when considering clinical hours only, where male family physicians earned more hourly (124.2 dollars vs 105.6 dollars), amounting to a 15% difference in pay (Table 1).

These findings add to mounting evidence that gender pay disparities persist and show that, for family medicine, this disparity is irrespective of hours worked. It is concerning that this gap exists only 3 years after graduation, as this minimizes the impact of seniority and experience as contributor factors. The causes of this pay disparity are multifactorial and not only merit further investigation but policy and health system attention in search of tangible solutions to ensure equal pay for an increasingly female workforce.

• Received for publication February 26, 2021.
• Revision received April 23, 2021.
• Accepted for publication April 27, 2021.