The First Step: Pay Equity in Medicine

Truer words were never spoken. Unfortunately, most of the online commentary cannot be shared in a family publication such as this, but it is notable that even Mad Magazine felt obligated to weigh in on the controversy, tweeting, “A male doctor is under fire after saying the pay gap exists because female physicians ‘do not work as hard,’ which is quite a claim, considering they have to do the exact same job all while fighting the urge to punch him in the face.”⁴ The prize for commentary under 140 characters, however, goes to the Huffington Post, which just tweeted a single word: “Yikes.”⁵

Some on social media have argued this story has already received enough oxygen, and that women physicians have been done two disservices: first by publishing the original account, and second by publicizing it further. I disagree. The last few years have proved to me that when ideas are allowed to hide in the darkness, they fester and grow. To kill a bad idea, you have to drag it into the light.

Christos Georghiou / shutterstock.com

Backpedaling does not appropriately capture the warp-speed with which Dr. Tigges tried to distance himself from his own comments, saying that his statement had been misconstrued.⁶ Even in this era of alternative facts, however, that explanation is hard to swallow. He had submitted the comments electronically, and with all due respect, his writing lacks a Joycean complexity that might lend to multiple interpretations.

In linguistics, the concept of the folk etymology, also known as analogical reformation, describe how a word or phrase is reanalyzed and changed by a listener who applies faulty logic that seems to make sense. The classic example is sparrowgrass, which arose from generations of Brits mishearing the word asparagus.⁷

Dr. Tigges basically created an intellectual folk etymology for himself. He made an observation, came up with an explanation, and the explanation seemed to make so much sense to him that he did not bother to double check his facts. But what are the facts?

The Facts

In 2018, Medscape surveyed 7,600 female physicians and compared their experiences to those of 12,729 male physicians across over 29 specialties. In its survey, male primary care physicians earned $33,000 more annually than women doing the same job; among specialists, that discrepancy increased to $95,000 per year.⁸

The problem with the data is that Medscape failed to take into account that almost twice as many women as men in its survey (22%) elected to work part time. The 2015 ACR Workforce Study noted that “females … are reported to work seven fewer hours each week on average and [have] fewer numbers of patient visits on average than their male counterparts. While overall females treated more patients than in 2005, females treat approximately 30% less than their male counterpart [sic].”⁹ So if more female physicians worked full time, would the discrepancy in salaries vanish?