White male doctors earn more than black male doctors--both earn more than female doctors

White male physicians in the United States earn substantially more than black male physicians, even after accounting for such factors as medical specialty, experience, and hours worked, according to a study published June 8, 2016 in The British Medical Journal.

The study also showed that differences in income by sex are larger than differences by race. While black female and white female physicians earn nearly the same, income for female physicians is significantly lower than that of male physicians.

“These findings are deeply concerning,” said senior author Anupam B. Jena, MD, PhD, Associate Professor of Health Care Policy and Medicine at Harvard Medical School and a faculty research fellow at the National Bureau of Economic Research in Boston, MA.

“If the goal is to achieve equity or to give incentives for the best students to enter medicine, we need to work on closing both the black-white gap and the gender gap in physician incomes," he added.

To investigate these income gaps, Dr. Jena and colleagues analyzed recent data from two nationally representative surveys (the American Community Survey conducted by the U.S. Census Bureau and physician surveys conducted by the Center for Studying Health System Change).

Their results showed that adjusted median annual incomes in 2010-2013 were:

• $253,042 for white male physicians compared with $188,230 for black male physicians—a $64,812 difference.

• $163,234 for white female physicians compared with $152,784 for black female physicians—a $10,450 difference.

• $249,164 for male physicians compared with $163,244 for female physicians—a $85,921 difference.

Although the results of the study quantified these income gaps, the numbers cannot provide explanations for these differences. In addition, such factors as hours worked, choice of specialty, percentage of revenue from Medicare or Medicaid, and years in practice also affect physicians’ incomes—even after the researchers adjusted for these factors.

For instance, though white male and black male physicians differ in average incomes, they work about the same number of hours per week—51.2 and 51.9. Meanwhile, male physicians work more hours on average than white female (45.2) or black female physicians (48.0), the researchers found.

Consider also that some specialties pay higher than others. White male physicians were the most likely to be in medical or surgical specialties, while black male physicians were the most likely to be in internal medicine, and black women were the most likely to be in pediatrics.

“Black male physicians are more likely to work in primary care and to treat Medicaid patients compared with white male physicians, both of which are associated with lower earnings,” the authors wrote. “Adjustment for these and other practice characteristics, however, did not eliminate—or even substantially reduce—the estimated differences in earnings.”

Other factors that need to be considered: whether black male physicians or female physicians have less bargaining power in salary negotiations, face employer discrimination, or have lower clinical revenue due to differences in patient volume, billing, or services provided.

“Further study is needed to understand the etiology of these race and sex differences, and whether they stem from disparities in job opportunity or other factors,” the researchers concluded.