Same hospital. Same training. Same contracted hours. Same patients.
If one physician is a man and one is a woman, she earns $21,000 less per year.
That is the result when you control for every confounder administrators use to explain the physician pay gap away.
A recent analysis ran the numbers on emergency medicine and the story got worse at every cut of the data:
Hourly pay, adjusted for workload: women earn $17 less per hour.
Mid-career: $28,000 less per year.
Late career: $40,000 less per year.
Under productivity-based pay: $59,000 less per year.
Over a full career, the compounded lost earnings land between $600,000 and $1,000,000. That is the house, the college tuition, the retirement account that gender quietly stripped.
Jake Horowitz told KevinMD that the male physician replies to this data read like a script. "Not in my hospital." "You must have controlled for hours wrong." "I have never seen that happen." He said the denial itself is the story. These studies have been published in JAMA and Doximity for 25 years. The numbers have not moved.
Emergency physician Resa E. Lewiss offered the remedy: a personal board of directors to pressure-test your compensation, a willingness to publish the gap when internal channels fail, and organizational accountability enforced by medical professional bodies with the power that individuals do not have.
One more point Resa raised that did not appear in the dataset: intersectionality. Race and ethnicity were not in this analysis. When historical studies have run those numbers, the salary disparities are even worse. The $21,000 baseline is an aggregate. For many women in this profession, the actual number is larger.
Jake Horowitz, who is not a physician, framed the stakes in terms every patient should understand. When you walk into an emergency department, you want a doctor who is focused, well-paid, and treated fairly. What you do not want is a doctor who has spent a decade watching the male colleague down the hall earn more for identical work while the institution insists the gap does not exist. That is not a personnel issue. That is a patient safety issue.
Bookmark this. The next time a health system tells you they "fixed this years ago," you will have the receipt to prove that the published academic literature has said otherwise for a quarter century and counting.
Listen to the full conversation on The Podcast by KevinMD. Link in the replies.
If you are a female physician who found out a male colleague earns more, what did you do next?
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