Pay disparities and gender

As we all know, a healthy work-life balance can be very difficult to achieve, let alone maintain. That is why many of us got into hospital medicine in the first place.

When studies show that in America, male hospitalists make more on average than their female counterparts, it is assumed that there is a strong correlation between hours worked and pay. But could there be other factors as well? In Canada, at least, that seems to be the case. A research team at the University of Montreal reviewed the billing information of 870 Quebec practitioners with a focus on procedures in elderly diabetic patients. Male and female practitioners were equally represented. The results: Female doctors were far more compliant with the Canadian Diabetes Association practice guidelines, but males were more productive when it came to procedures.

Specifically, male physicians reported close to 1,000 more procedures annually compared with female physicians. So, the question comes to mind: Who is more profitable for hospitals, physicians who perform more procedures that can be billed at a higher rate, or those who seem to focus more attention on the bread and butter of care, so to speak? After all, if patients understand their condition and get the appropriate care, aren't they less likely to require rehospitalization? No definitive answers yet, but this study does make you want to go, "Hmm."

While the U.S. health care system certainly differs from Canada's, this article does bring up intriguing issues, some which just may be worth considering as we assess and improve the practice styles and compensation models for hospitalists. A 2012 Today's Hospitalist survey cited in an article titled, "Why do women hospitalists make less money?" sheds additional light on the subject. Yes, there is still a gender gap between male and female physicians. There are numerous hypotheses, as well as some hard data to explain some of these differences, though many still believe part of the issue is a persistent gender bias.

The article noted that males work a few more shifts than females, 16.68 vs 15.96, but this is only a 5% difference in work hours. Other data support a compensation difference based on the different payment models. Slightly more men are in a payment model that is 100% productivity-based or a combination of salary and productivity, and these models tend to pay more than do positions that are straight salary. Still, for a variety of reasons, some clear and others obscure, female hospitalists earn an average of $35,000 less than do their male counterparts.

Acknowledging a disparity exists is not enough. The reasons for this disparity should be further evaluated and addressed. Perhaps they are strongly the result of lifestyle choices, types of positions females prefer, and other nongender-related issues, but we owe it ourselves to gain further clarity on this very real issue.

Dr. Hester is a hospitalist with Baltimore-Washington Medical Center who has a passion for empowering patients to partner in their health care. She is the creator of the Patient Whiz, a patient-engagement app for iOS.

As we all know, a healthy work-life balance can be very difficult to achieve, let alone maintain. That is why many of us got into hospital medicine in the first place.

When studies show that in America, male hospitalists make more on average than their female counterparts, it is assumed that there is a strong correlation between hours worked and pay. But could there be other factors as well? In Canada, at least, that seems to be the case. A research team at the University of Montreal reviewed the billing information of 870 Quebec practitioners with a focus on procedures in elderly diabetic patients. Male and female practitioners were equally represented. The results: Female doctors were far more compliant with the Canadian Diabetes Association practice guidelines, but males were more productive when it came to procedures.

Specifically, male physicians reported close to 1,000 more procedures annually compared with female physicians. So, the question comes to mind: Who is more profitable for hospitals, physicians who perform more procedures that can be billed at a higher rate, or those who seem to focus more attention on the bread and butter of care, so to speak? After all, if patients understand their condition and get the appropriate care, aren't they less likely to require rehospitalization? No definitive answers yet, but this study does make you want to go, "Hmm."

While the U.S. health care system certainly differs from Canada's, this article does bring up intriguing issues, some which just may be worth considering as we assess and improve the practice styles and compensation models for hospitalists. A 2012 Today's Hospitalist survey cited in an article titled, "Why do women hospitalists make less money?" sheds additional light on the subject. Yes, there is still a gender gap between male and female physicians. There are numerous hypotheses, as well as some hard data to explain some of these differences, though many still believe part of the issue is a persistent gender bias.

The article noted that males work a few more shifts than females, 16.68 vs 15.96, but this is only a 5% difference in work hours. Other data support a compensation difference based on the different payment models. Slightly more men are in a payment model that is 100% productivity-based or a combination of salary and productivity, and these models tend to pay more than do positions that are straight salary. Still, for a variety of reasons, some clear and others obscure, female hospitalists earn an average of $35,000 less than do their male counterparts.

Acknowledging a disparity exists is not enough. The reasons for this disparity should be further evaluated and addressed. Perhaps they are strongly the result of lifestyle choices, types of positions females prefer, and other nongender-related issues, but we owe it ourselves to gain further clarity on this very real issue.

Dr. Hester is a hospitalist with Baltimore-Washington Medical Center who has a passion for empowering patients to partner in their health care. She is the creator of the Patient Whiz, a patient-engagement app for iOS.

As we all know, a healthy work-life balance can be very difficult to achieve, let alone maintain. That is why many of us got into hospital medicine in the first place.

When studies show that in America, male hospitalists make more on average than their female counterparts, it is assumed that there is a strong correlation between hours worked and pay. But could there be other factors as well? In Canada, at least, that seems to be the case. A research team at the University of Montreal reviewed the billing information of 870 Quebec practitioners with a focus on procedures in elderly diabetic patients. Male and female practitioners were equally represented. The results: Female doctors were far more compliant with the Canadian Diabetes Association practice guidelines, but males were more productive when it came to procedures.

Specifically, male physicians reported close to 1,000 more procedures annually compared with female physicians. So, the question comes to mind: Who is more profitable for hospitals, physicians who perform more procedures that can be billed at a higher rate, or those who seem to focus more attention on the bread and butter of care, so to speak? After all, if patients understand their condition and get the appropriate care, aren't they less likely to require rehospitalization? No definitive answers yet, but this study does make you want to go, "Hmm."

While the U.S. health care system certainly differs from Canada's, this article does bring up intriguing issues, some which just may be worth considering as we assess and improve the practice styles and compensation models for hospitalists. A 2012 Today's Hospitalist survey cited in an article titled, "Why do women hospitalists make less money?" sheds additional light on the subject. Yes, there is still a gender gap between male and female physicians. There are numerous hypotheses, as well as some hard data to explain some of these differences, though many still believe part of the issue is a persistent gender bias.

The article noted that males work a few more shifts than females, 16.68 vs 15.96, but this is only a 5% difference in work hours. Other data support a compensation difference based on the different payment models. Slightly more men are in a payment model that is 100% productivity-based or a combination of salary and productivity, and these models tend to pay more than do positions that are straight salary. Still, for a variety of reasons, some clear and others obscure, female hospitalists earn an average of $35,000 less than do their male counterparts.

Acknowledging a disparity exists is not enough. The reasons for this disparity should be further evaluated and addressed. Perhaps they are strongly the result of lifestyle choices, types of positions females prefer, and other nongender-related issues, but we owe it ourselves to gain further clarity on this very real issue.

Dr. Hester is a hospitalist with Baltimore-Washington Medical Center who has a passion for empowering patients to partner in their health care. She is the creator of the Patient Whiz, a patient-engagement app for iOS.