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Original Investigation |

Sex Differences in Physician Salary in US Public Medical Schools

Anupam B. Jena, MD, PhD1,2,3; Andrew R. Olenski, BS1; Daniel M. Blumenthal, MD, MBA4,5
[+] Author Affiliations
1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
2Department of Medicine, Massachusetts General Hospital, Boston
3National Bureau of Economic Research, Cambridge, Massachusetts
4Cardiology Division, Massachusetts General Hospital, Boston
5Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2016;176(9):1294-1304. doi:10.1001/jamainternmed.2016.3284.
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Importance  Limited evidence exists on salary differences between male and female academic physicians, largely owing to difficulty obtaining data on salary and factors influencing salary. Existing studies have been limited by reliance on survey-based approaches to measuring sex differences in earnings, lack of contemporary data, small sample sizes, or limited geographic representation.

Objective  To analyze sex differences in earnings among US academic physicians.

Design, Setting, and Participants  Freedom of Information laws mandate release of salary information of public university employees in several states. In 12 states with salary information published online, salary data were extracted on 10 241 academic physicians at 24 public medical schools. These data were linked to a unique physician database with detailed information on sex, age, years of experience, faculty rank, specialty, scientific authorship, National Institutes of Health funding, clinical trial participation, and Medicare reimbursements (proxy for clinical revenue). Sex differences in salary were estimated after adjusting for these factors.

Exposures  Physician sex.

Main Outcomes and Measures  Annual salary.

Results  Among 10 241 physicians, female physicians (n = 3549) had lower mean (SD) unadjusted salaries than male physicians ($206 641 [$88 238] vs $257 957 [$137 202]; absolute difference, $51 315 [95% CI, $46 330-$56 301]). Sex differences persisted after multivariable adjustment ($227 783 [95% CI, $224 117-$231 448] vs $247 661 [95% CI, $245 065-$250 258] with an absolute difference of $19 878 [95% CI, $15 261-$24 495]). Sex differences in salary varied across specialties, institutions, and faculty ranks. For example, adjusted salaries of female full professors ($250 971 [95% CI, $242 307-$259 635]) were comparable to those of male associate professors ($247 212 [95% CI, $241 850-$252 575]). Among specialties, adjusted salaries were highest in orthopedic surgery ($358 093 [95% CI, $344 354-$371 831]), surgical subspecialties ($318 760 [95% CI, $311 030-$326 491]), and general surgery ($302 666 [95% CI, $294 060-$311 272]) and lowest in infectious disease, family medicine, and neurology (mean income, <$200 000). Years of experience, total publications, clinical trial participation, and Medicare payments were positively associated with salary.

Conclusions and Relevance  Among physicians with faculty appointments at 24 US public medical schools, significant sex differences in salary exist even after accounting for age, experience, specialty, faculty rank, and measures of research productivity and clinical revenue.

Figures in this Article

Figures

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Figure 1.
Salary Distribution by Sex

Distribution of salaries among 10 241 male and female physician faculty in 24 US public medical schools.

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Figure 2.
Sex Differences in Salary According to Medical School

School-specific sex differences in salary were estimated using a multivariable linear regression of salary as a function of age, years of experience, sex (interacted with school), National Institutes of Health funding, publication count (total as well as being first or last author on publications), clinical trial participation, and Medicare payments. See the Salary Data subsection of the Methods section for a list of the included schools. Limit lines indicate 95% CI.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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Statistical Analysis
Posted on July 11, 2016
Allan R. Glass, M.D.
N/A
Conflict of Interest: None Declared
It appears from inspection of Figure 1 that the salary profiles are not normally distributed, which might be a factor in interpreting multiple linear regression analysis. The shape of the curves suggests that a log transformation of the salary data might lead to normally distributed data. It would be of interest to repeat the linear regression analysis after log-transformation of the data.
Differences in working hours
Posted on August 17, 2016
Kyoungwoo Kim
Dept. Family Medicine, Seoul Paik Hospital
Conflict of Interest: None Declared
We should consider working hour differences first. Salary differences may result from working hour differences, not sex differences.
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