Updated on: May 14, 2018

The Gender Wage Gap Cannot Be Accepted

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Original story posted on: April 13, 2018

Women earn less than men in nearly every single occupation.

Recently, I left my home base in southeastern Wisconsin and landed in the warm and humid landscape that is Orlando to attend Hospital Medicine 2018, hosted by the Society of Hospital Medicine. It’s a bit of a homecoming as this impressive group of physicians from all over the country is my original medical clan as a former pediatric hospitalist. 

Looking out over the landscape of thousands of attendees surging in between educational sessions, I’m struck by the undeniable parity between women and men present here. It’s one of the most equal distributions of gender I’ve ever seen in a large group of physicians, and makes the topic of this piece even more confusing, in my mind.

Women are almost half of the workforce in the United States. But historically, they earn less than men in nearly every single occupation. According to the Institute of Women’s Policy Research, in 2016, female full-time employees made only 80.5 cents for every dollar earned by their male counterparts, for a wage gap of 20 percent. A few weeks ago, Doximity released its second annual Physician Compensation Report. Based on more than 65,000 physician respondents, they found that between 2016 and 2017, compensation rose four percent nationally. But when accounting for gender, female doctors earn 27.7 percent less than male doctors. This amounts to a whopping $105,000 less annually for female physicians. Even more frustrating, this gap INCREASED by 1.2 percent in 2017 compared to 2016! 

Focusing on physicians, let’s forgo occupational segregation and taxing motherhood (i.e., the concepts that women are marginalized into lower-paying jobs and paid less when they return to the workplace after taking time away to raise small children) and concentrate on sexism.

Are thousands of health systems and physician groups around the country truly asserting their female physicians are less valuable or qualified than their male physicians? Do they stand by the argument that men are historically the primary breadwinners, and need to be paid more to support their families? Is paying female physicians less than their male counterparts a legitimate method of cost control? These are the exact questions which should be asked by any woman who learns she is being paid less than her male peers, immediately followed by a demand for equalization of salary the following month. 

I understand that this is easier said than done. Few of us seek out conflict, especially with our employers, and the idea of asking for a raise is notoriously difficult for men and women alike. But this has to be viewed in a different light. First of all, this is not asking for a raise. It’s demanding to be treated fairly and with the respect deserved. Any argument against this conversation is simply invalid. Second, it’s a piece of a larger problem. What other concerning mindsets and decisions are being made in an institution which is comfortable with placing a percentage of its medical staff in a lesser category than others simply based on its sex?

For the entirety of my clinical practice, I was aware of the salary for each of my group’s members because we negotiated and discussed salary with our hospital administrators as a unit. New physicians who came into our fold were paid the same as those of us who’d been there for years, as we were all performing the same job. Male or female, experienced or just out of residency, we were all paid the same. As a physician advisor, I am the first and only in my health system, so there is no peer or historical salary of a predecessor to compare to. But you can be certain that once we start adding more into the ranks, I will pointedly ask about pay. While this should not be a concern, it most certainly is.

Like any other concern, in my opinion, it’s best to face it head-on instead of waiting for the other shoe to drop.



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Juliet B. Ugarte Hopkins, MD, CHCQM

Juliet B. Ugarte Hopkins, MD, CHCQM-PHYADV, is a physician advisor for case management, utilization, and clinical documentation at ProHealth Care, Inc. in Wisconsin. Dr. Ugarte Hopkins practiced as a pediatric hospitalist for a decade. She was also medical director of pediatric hospital medicine and vice chair of pediatrics in Northern Illinois before transitioning into her current role. She is the first physician board member for the Wisconsin chapter of the American Case Management Association (ACMA), a member of the RACmonitor editorial board, and a member of the board of directors for the American College of Physician Advisors (ACPA). Dr. Ugarte Hopkins also makes frequent appearances on Monitor Mondays.