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Health Centers Need to Address Provider Gender Pay Inequities


On International Women’s Day, we thought it appropriate to begin the release of information from Merces’ FQHC Provider Productivity and Compensation Survey, the only study of its kind, with data on how female providers’ pay stacks up with their male colleagues.  The average salary for a female physician ($174,048) is approximately 93% of the average salary of a male physician ($187,020).  OB physicians were excluded from these calculations in order to avoid potential distortions of the results, but the result among this specialty is the same, with females at 92% of males.  Similarly, female physician assistants earn 93% of the average salary of their male counterparts (93,235, compared to 99,818). This pattern continues, even after controlling for clinic setting, health center size, and experience.  While there are combinations of factors in which women earn more, they are all those with very small samples.

While the gender pay differential among physicians is not as striking as the 15% pay gap Merces identified among FQHC CEOs earlier this year, it is still troubling, considering that there is only a statistically insignificant gap in productivity between male and female providers, with female physicians having an average of 3,264 patient encounters per year, compared to 3,251 for men.  As expected, this varies, sometimes widely, when accounting for clinic setting, health center size, provider experience and provider specialty, but there are only a few situations where male provider productivity appears even moderately higher than that of similarly situated female providers.

Productivity is, of course, only one of many factors to consider in analyzing pay, but as it has been the measure seemingly at the forefront of discussions of pay, and with a focus on “performance-based” pay programs, Merces reviewed the effectiveness of pay programs in rewarding productivity.  Male and female family practice physicians were placed into three groups in each of two categories — productivity and salary.  The “low” group included those in the lower 25% of each measure; “middle” referred to the middle 50% of the sample; and “high” the highest 25%.   Absent any other factor, we would assume that relatively equal percentages of male and female providers would fall in the nine possible “blocks.”

The distribution of providers by productivity between males and females was as it would be expected — virtually the same.  Controlling for productivity, however, when it came to pay, more male providers fell into the “high salary” category (34%) than women (21%).  Further, despite the similar level of productivity, the “high performing/high salary” group of male providers made up 12.5% of the male providers, four times more than the similar group of females, who made up only 3.7% of the female providers.

Whether by absolute numbers or comparisons of “categories” based on performance and pay, there appears to be a disconnect between male and female provider compensation that should be addressed if health centers truly want to improve their recruitment and retention experiences.