Examining the Gender Pay Gap Among Primary Care Physicians

Dr. Hannah Neprash

New research led by researchers at Harvard University and the University of Minnesota finds that that female primary care physicians earn less revenue than men for the care they provide, but spend more time with patients than their male colleagues, dispelling the commonly held opinion that female physicians work fewer hours than men.

The researchers used a novel combination of all-payer insurance claims and electronic health record data and constructed measures of patient care revenue, visit volume, and visit length (in minutes) over the course of 2017. They found that:

• Annually, female primary care physicians earned 10.9 percent less total visit revenue than male physicians and conducted 10.8 percent fewer visits, yet they spent 20 additional hours (2.6 percent more visit time) with patients.
• At the visit-level, revenue was identical for male and female primary care physicians, but woman doctors placed more orders, documented more diagnoses, and spent 2.4 minutes (15.7 percent) longer with their patients. Longer individual visits meant lower annual visit volume, resulting in lower total revenue for female physicians.
• The additional time spent in each appointment means that, on average, female physicians were paid 87 cents to the dollar per hour of face-to-face work, compared to their male colleagues.

Hannah Neprash, senior author of the study and an assistant professor in the School of Public Health at the University of Minnesota, explains that “it all comes down to time. The disconnect between time spent and revenue generated may help to explain why female physicians — especially primary care physicians — face greater potential for job burnout. For example, women may experience declining morale because they may want to spend extra time with their patients; feel pressure from their employers to treat more people; and earn less money despite doing more work.”

Dr. Neprash is a graduate of Oberlin College in Ohio, where she majored in economics. She holds a Ph.D. in health policy from Harvard University.

The full study, “Physician Work Hours and the Gender Pay Gap — Evidence From Primary Care,” was published in the New England Journal of Medicine. It may be accessed here.