Why Women Doctors Make Half of What Men Do: Medicare’s Doctor Gender Pay Gap

Why Women Doctors Make Half of What Men Do

Female doctors are pulling in only about half as much money as their male counterparts in the Medicare system — the nation’s largest insurer — according to a new study by NerdWallet Health. While Medicare pays both men and women equally for providing the same service, several factors may contribute to women earning much less over the course of a year. This study shows how the gender pay gap is affecting the nation’s more than 800,000 physicians.

Key findings

On average, male doctors are paid 88% more in annual Medicare reimbursements. Men make $118,782 per year from Medicare; women are paid $63,346. While Medicare reimbursement is only one component of physician salary, our study found:

  • Male physicians see 60% more patients. On average, women doctors treat 320 Medicare patients a year, while men treat 513.
  • Male doctors make more money per patient treated.  On average, they make 24% more treating each patient than female doctors do.
  • Male doctors perform more services per patient treated.  To explore this, NerdWallet Health devised a metric to calculate a physician’s average “service volume” per patient. We found that male doctors billed Medicare, on average, for one more procedure per patient than female physicians (5.7 services performed per patient by male doctors vs. 4.7 services per patient by female doctors).
  • This gap in service volume is true across specialties. Male doctors performed more services per patient than female doctors across nearly all specialties. In a specialty like pathology – where doctors infrequently provide services directly to patients – we found no variation in average service volume.

NerdWallet Health research highlights inconsistencies in the way medicine is practiced by American doctors. It does not show that one gender practices better medicine or provides higher quality care than the other. Prior research has shown that male doctors generally work more hours, which could increase their billings to Medicare. Men also dominate high-paying surgical fields; women make up less than 10% of Medicare physicians in surgical specialties like cardiac, orthopedic, and neurosurgery.

Still, this new NerdWallet research points to a larger issue with Medicare. Because Medicare pays through a fee-for-service system, doctors have a financial incentive to provide more services. More services means patients incur additional costs. These costs are both financial, in the form of additional copayments, as well as medical, in the form of increased exposure to a health care system in which over 210,000 patients die annually from medical errors.

While this study suggests that practice variation exists between men and women physicians, there are other important factors that may impact this gender pay gap. These influences include:

  • Geography: Medicare payments vary by location. If female physicians are congregated in lower paying ZIP codes, this could contribute to the discrepancy.
  • Coding variations: Medicare payments vary by the type of service provided. Men may be performing more highly reimbursed procedures than their female counterparts are.
  • Care setting: Medicare typically pays less to physicians when procedures are performed in a hospital setting rather than in a clinic. If women are more likely to be hospital-based, that may be why they are receiving less reimbursement from Medicare–even within specialties.
  • Missing data: Due to privacy concerns, Medicare withheld data when less than 11 patients were treated by an individual doctor for a given procedure code. It is possible that women physicians are more likely to have procedures or patient volumes that fall into this low range.


 The Medicare Doctor Gender Pay Gap

Embed this on your own site:

 

Physician Specialty Total Physicians Average Medicare Payment (Women) Average Medicare Payment (Men) Average Patients Treated (Women) Average Patients Treated (Men) Payment Per Patient (Women) Payment Per Patient (Men) Service Volume (Women) Service Volume (Men) Service Volume Discrepancy Women Physicians Men Physicians
Internal Medicine 88,753 $63,741 $112,662 264 400 $232 $278 4.6 5.9 29% 34% 66%
Family Practice 76,072 36,620 66,944 198 299 178 211 4.3 5.4 25% 35% 65%
Emergency Medicine 36,237 48,372 62,110 391 494 122 124 1.5 1.6 9% 25% 75%
Anesthesiology 31,699 20,063 30,249 146 176 145 167 1.5 1.9 28% 22% 78%
Diagnostic Radiology 27,926 97,753 125,849 1,519 2,046 84 86 2.9 3.1 9% 21% 79%
Obstetrics/Gynecology 22,789 11,324 15,653 94 106 96 115 2.0 2.4 17% 49% 51%
Cardiology 21,815 136,586 234,243 879 1,146 188 235 3.1 3.9 25% 11% 89%
Psychiatry 21,229 23,210 39,442 113 166 206 238 4.4 4.9 12% 33% 67%
Orthopedic Surgery 20,093 50,401 106,744 209 330 203 279 4.2 5.3 26% 4% 96%
General Surgery 18,221 33,339 51,435 157 217 203 227 2.1 2.4 17% 15% 85%
Ophthalmology 16,732 174,894 366,505 511 824 297 404 3.4 4.1 22% 20% 80%
Neurology 12,077 71,862 114,304 277 402 255 275 6.2 7.4 18% 27% 73%
Gastroenterology 11,781 66,346 119,211 295 483 212 238 2.4 2.6 8% 13% 87%
Pathology 10,839 74,238 97,077 678 854 105 105 3.0 3.0 0% 36% 64%
Dermatology 10,298 132,327 273,400 516 855 244 319 4.8 5.7 18% 42% 58%
Pulmonary Disease 8,666 99,682 164,518 371 556 258 292 3.4 4.3 26% 16% 84%
Urology 8,643 93,747 162,537 378 592 222 267 5.0 5.7 13% 6% 94%
Otolaryngology 8,282 52,870 79,590 283 415 178 188 3.4 3.7 8% 12% 88%
Nephrology 7,331 161,812 244,908 386 502 410 488 7.4 9.5 28% 23% 77%
Hematology/Oncology 7,199 233,796 425,673 296 406 540 802 32.9 53.2 62% 28% 72%
Physical Medicine/Rehabilitation 6,833 90,879 133,949 257 336 344 397 8.4 10.3 23% 32% 68%
General Practice 6,341 44,279 61,757 163 230 257 263 5.8 6.0 3% 21% 79%
Endocrinology 4,653 56,414 100,500 280 421 184 215 3.8 5.2 38% 43% 57%
Infectious Disease 4,642 85,851 124,609 267 355 273 306 13.1 18.1 38% 36% 64%
Radiation Oncology 4,050 243,646 405,891 190 250 1,417 1,819 12.5 15.2 21% 25% 75%
Neurosurgery 4,047 40,178 77,624 145 215 255 317 2.3 2.5 8% 5% 95%
Rheumatology 3,954 150,813 325,942 267 430 423 632 13.0 20.9 61% 38% 62%
Plastic/Reconstructive Surgery 3,645 20,617 38,314 86 125 154 217 2.1 2.3 9% 12% 88%
Allergy/Immunology 3,069 31,644 60,932 107 182 286 322 20.4 24.7 21% 28% 72%
Vascular Surgery 2,630 88,885 189,116 439 653 255 364 2.5 3.3 34% 8% 92%
Medical Oncology 2,545 196,839 361,007 279 351 469 745 23.4 45.2 93% 28% 72%
Critical Care 2,113 62,681 104,762 210 317 299 332 2.8 3.4 21% 21% 79%
Thoracic Surgery 1,841 46,323 82,241 122 187 387 531 2.0 2.3 15% 6% 94%
Interventional Pain Management 1,823 127,146 208,362 275 393 419 516 8.9 11.9 33% 12% 88%
Geriatric Medicine 1,716 77,899 114,101 290 373 252 289 3.9 5.0 26% 45% 55%
Cardiac Surgery 1,509 55,551 120,071 216 218 471 701 2.1 2.4 11% 4% 96%
Pediatric Medicine 1,434 23,013 37,326 130 175 249 195 6.4 5.5 -14% 39% 61%
Colorectal Surgery 1,201 31,313 59,317 162 254 177 216 2.0 2.2 9% 18% 82%
Pain Management 1,133 86,373 157,974 230 325 341 445 6.7 9.2 38% 16% 84%
Hand Surgery 1,108 44,072 68,388 211 296 182 205 3.5 3.9 10% 10% 90%
Cardiac Electrophysiology 1,093 123,123 191,711 834 1,090 173 212 2.9 3.1 7% 11% 89%
Other 6,096 51,441 97,741 227 426 262 290 6.4 8.0 25% 25% 75%
Overall: 534,158 $63,346 $118,783 319 512 $211 $262 4.7 5.7 21% 27% 73%

NerdWallet Health Analysis of 2012 CMS Provider Utilization and Payment Data.

 
Source:
Centers for Medicare and Medicaid Services 2012 Provider Utilization and Payment Data: Physician and Other Supplier Public Use File. Available online. Selection criteria included physicians listing an M.D. or D.O. credential and a gender.  Service Volume calculation based on [total_provider_services] divided by [total_unique_benes].
 
About NerdWallet:
NerdWallet Health helps patients make smarter decisions and save money on their health care. Our award winning Best Hospitals Price Comparison application empowers patients to quickly compare the price of hospital care across 3200 hospitals in 50 states. Our Ask a Medical Advisor application is the first online Q&A platform that gives patients free and personalized expert advice to reduce their medical bills. Learn more at www.nerdwallet.com/health.


Male and female doctors looking at tablet image via Shutterstock.

We want to hear from you and encourage a lively discussion among our users. Please help us keep our site clean and safe by following our posting guidelines, and avoid disclosing personal or sensitive information such as bank account or phone numbers. Any comments posted under NerdWallet's official account are not reviewed or endorsed by representatives of financial institutions affiliated with the reviewed products, unless explicitly stated otherwise.