Female-Dominated Pediatrics Still Has Wage Gap

Marcia Frellick

September 10, 2019

Even as women make up 63% of the pediatrician workforce, a pay gap persists within the specialty, according to a study published online today in Pediatrics.

Mary Pat Frintner, MSPH, with the Department of Research at the American Academy of Pediatrics (AAP) in Itasca, Illinois, and colleagues found that early- and midcareer female pediatricians make 94% of what their male colleagues do, after adjusting for all factors for which data were available.

The difference adds up to an average $8000 less a year, $229,000 less over 20 years, and $400,000 less over 30 years, assuming a 3% rate of inflation each year. The calculations include adjustments for a comprehensive set of labor force, physician-specific job, and work-family characteristics, including marital status, number of hours worked, number of children, practice setting, years in current position, region, compensation method, and subspecialties.

A companion study, also published in Pediatrics, shows that female pediatricians also spend more time on household tasks and report less satisfaction in their work-life mix than do their male counterparts.

Amy J. Starmer, MD, MPH, with the Department of Medicine at Boston Children's Hospital in Massachusetts, is an author on both articles. In the household work distribution study, she and colleagues write that female pediatricians more often reported being the person in their household responsible for 13 of 16 tasks, including cooking, cleaning, and childcare.

Findings from the study include the following:

  • 62% of women and 17% of men reported having primary responsibility for laundry.

  • 52% of women and 6% of men reported being primarily responsible for helping their child with homework.

  • Half of female pediatricians and one third of male pediatricians reported always feeling rushed.

  • Female pediatricians were less likely than male counterparts to report satisfaction with distribution of household responsibilities (52.3% vs 62%).

"There's a real opportunity for the AAP and other organizations, as well as male and female pediatricians, to work for solutions to ensure gender equity in the profession," Starmer told Medscape Medical News.

Data From PLACES

In comparing pay and household responsibilities, the researchers examined cross-sectional 2016 data from the AAP Pediatrician Life and Career Experience Study (PLACES), a long-term study of early- and midcareer pediatricians.

Starmer said the results are particularly surprising given the specialty studied.

"Pediatricians have devoted their careers to the care of children in the professional sense, and one might think they would be more sensitive to these distributions and more sensitive to work/life balance. But even in this field, these discrepancies were still present," she said.

She said the researchers were surprised that when female pediatricians were asked about what might help improve the imbalance, few answered that better distribution of tasks at home would help.

The authors write, "It has been suggested that patterns of inequitable household responsibilities may start as early as childhood, suggesting the possibility that inequitable responsibilities may be considered the norm."

Strategies for negotiating with a spouse or partner about sharing household tasks or considering outsourcing help are not topics typically addressed at conferences, she noted, "but maybe they should be."

The imbalances may have far-reaching consequences, the articles suggest.

Starmer said prior research has found that maldistribution of responsibilities has been associated with burnout and that some studies suggest there could be problems related to patient safety.

The authors say that although they did not specifically study the effect on workplace leadership roles, their findings of inequities in household roles and challenges in work/life balance may contribute to inequities in leadership roles in the workplace.

Starmer acknowledged that they could not adjust for all possible factors, only those for which data were available, so it is unclear whether only gender explains the gap.

In an accompanying editorial, Anita Raj, PhD, with the Departments of Education Studies and Medicine, Center on Gender Equity and Health, University of California, San Diego, said that after adjusting for other factors, the pay gap "may be attributable to ongoing gender discrimination in the workplace," but noted that such discrepancies persist by race and/or ethnicity as well.

She found cause for optimism in the study, noting that the pediatrician gender wage gap is less than the gap for all physicians and is even less than in the general US workforce.

"Hence, pediatrics appears to be managing the gender wage gap better than most," she said.

Both studies were supported by the AAP. The study authors and editorialist Raj report no relevant financial relationships.

Pediatrics. Published online September 10, 2019. Frintner et al, Abstract; Starmer et al, Abstract; Editorial

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