Earnings gaps exist between black and white male physicians, male and female physicians

White male physicians in the United States earn substantially more than black male physicians, even after accounting for medical specialty, years of experience, and hours worked each week, researchers reported. In addition, while incomes of black and white female physicians are similar to each other, they are significantly lower than men's.

Researchers estimated differences in income by race and sex among U.S. physicians using data from 2 sources: the 2000-2013 American Community Survey (ACS), a nationally representative, cross-sectional survey of about 3 million households annually, administered by the U.S. Census Bureau, and the 2000-2008 Center for Studying Health System Change (HSC) physician survey, which provided representative samples of physicians across 51 metropolitan areas and 9 nonmetropolitan areas and is supplemented by a national sample. Annual income was adjusted for several factors from both surveys, including age, specialty, hours worked, years in practice, and percentage of revenue from Medicare and Medicaid.

Results were published online by The BMJ on June 7.

In the ACS, mean annual income was highest among white male physicians ($255,383), followed by black male physicians ($210,544; P<0.001 compared with white men), white female physicians ($174,106; P<0.001 compared with white men), and black female physicians ($166,833; P<0.001 compared with white men). Mean age was highest among white men at 53.2 years, which was about 7 years older than the lowest mean age of the groups, black women at 46 years. The average number of hours worked per week was 51.2 for white male physicians and 51.9 for black male physicians (P=0.08), both of which were greater than the 45.2 for white female physicians and 48.0 for black female physicians.

Also from the ACS, differences in median income by race did not significantly vary over the study period. During 2000-2004, the adjusted difference in median income was $27,108 ($183,258 vs. $156,150; 95% CI for difference, $18,118 to $36,097), compared with $37,841 in 2005-2009 ($209,803 vs. $171,962; 95% CI, $31,068 to $44,613; P=0.06 for difference compared with difference in 2000-2004) and $34,141 in 2010-2013 ($228,585 vs. $194,444; 95% CI, $21,746 to $46,535; P=0.37 for difference compared with difference in 2000-2004).

Because differences in physicians' income by race estimated from the ACS did not adjust for physician specialty or practice characteristics, researchers also analyzed data from the HSC physician surveys. From these data, researchers learned that 27.3% of white male physicians made $150,000 or less compared with 40.8% of black male physicians (absolute difference, 13.5%; 95% CI, 9.6% to 17.4%). However, 59.4% of white female physicians made $150,000 or less compared with 58.8% of black female physicians. On the other end of the earning spectrum, 30.9% of white male physicians made above $250,000, compared with 18.3% of black male physicians (absolute difference, 12.5%; 95% CI, 8.5% to 16.6%). Similarly, 9.6% of white female physicians made above $250,000, compared with 7.3% of black female physicians (absolute difference, 2.3%; 95% CI, −0.9% to 5.6%).

The researchers wrote that race- and sex-based disparities in earnings potential “cannot be closed simply by opening up opportunities for minorities and women in higher paying specialties” and said “efforts to eliminate these disparities might need to look beyond medical school admissions and training to the broader workplace.”