By Jamie Ducharme
April 10, 2019

Despite the often-quoted statistic that women in the U.S. make 80 cents for every dollar earned by men, the actual figure varies depending on a woman’s race, geographic location and industry. Women of color, for example, have an even larger pay gap than white women. And women in certain fields, such as financial services, are further from pay parity than their peers in other professions.

Medicine has traditionally been one of those imbalanced fields — and the latest physician compensation report from Medscape, a medical news site for healthcare professionals, finds that the situation is getting worse for many doctors.

According to Medscape’s 2019 report, which polled about 20,000 U.S. doctors in 30 specialties, pay for physicians has risen by about 20% for both primary care physicians and specialists since 2015. But increases have not been equal for male and female doctors.

In 2018, male primary care physicians earned about 18% more than their female colleagues, according to the report. By 2019, that gulf had widened to 25% — meaning the average male doctor made $258,000 per year, while the average female physician earned $207,000. The pay gap among specialists was larger to begin with, but it narrowed slightly, from 36% in 2018 to 33% in 2019. The average male specialist’s salary is now $372,000, compared to $280,000 for female specialists.

A racial pay gap also persists in medicine, the report finds. Average income for a white doctor is $319,000, compared to $303,000 for Hispanic and Latino doctors, $300,000 for Asian doctors and $281,000 for black doctors.

In total, male doctors spend about 9% more time with patients each week than female doctors, according to the report, while women spend a bit more time on paperwork and administrative tasks. (That’s important, since a physician’s salary often depends at least partly on how many patients they see.) Women also tend to go into primary care or lower-paying specialties, while men often gravitate toward high-paying areas such as orthopedics, plastic surgery and cardiology.

Those disparities explain some of the pay gap, the researchers write, but other factors are likely at play.

Dr. Maryam Asgari, an associate professor of dermatology at Harvard Medical School, co-wrote a recent viewpoint article in JAMA about how to close the physician pay gap. (She was not involved with the Medscape report.)

“It’s not just about, are you given the same contract? It’s about, are you given the same support?” says Asgari, who says that she has faced situations where male colleagues were given better operating schedules that allowed them to see more patients, and therefore generate more revenue and income. “The problem is much more pervasive than people really understand. There’s a lot of implicit bias that’s at play. Sometimes implicit bias and male versus female styles can influence perception of productivity.”

To make significant progress, institutions will have to be transparent not only about pay, but also about how they’re assessing and working toward salary equity, Asgari says. “Figuring out how different institutions are gaining some transparency around the process, and figuring out what best practices are, will get us a long way toward rolling out more salary equity,” she says.

Write to Jamie Ducharme at jamie.ducharme@time.com.

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