Discrimination of Women Physicians in Medicine

Since the early 20th century, women have faced discrimination in medicine by male physicians and patients which has created a stratification within the occupation affecting: income, specialty and job security/burn-out of women. Women have also reported many instances of harassment by their male patients and co-workers which has further erupted the discrimination they face. This paper herein, seeks to quantify the exact nature of the issue and propose many possible solutions that could alleviate the problem at hand at the perspective of a political economists. Women have, since the early 20th century, entered medical school at an increasing proportion each consecutive year and currently outnumber their male colleagues. It need not be overlooked that medicine has taken an initiative in increasing their female population over the past decades.

However, the average income, reports of harassment, and specialty choice of women don’t seem to compliment the outreach. The medical industry has created a curtain of deceit by statistically inflating their cover-ups to over-shadow their hidden discriminatory views toward women in medicine. In a sense, they believe that by increasing the proportion of women to men, that people will forget about the recurring issues that women face independent of the ratio of gender. Numbers can fool people into believing anything, and hospitals are aware of this. However, they have not fooled everyone. Scientists (including economists) have reported studies exposing them of their neglect toward their women faculty and this paper will reveal those results respectively.

Women physicians currently do not earn equal salaries as compared to male physicians on average. With respect to a given specialty, women are out-payed across the board. Women are also less reluctant to enter specialties that pay higher due to insecurities, self-doubt, fear and home burdens. The lack of women in high-paying specialties is not supported by the claim that women aren’t as competent as men. In-fact, women are just as, or even more competent than men on average. Studies show that women earn higher average GPA’s than males do and has been prevalent since women entered the educational system in the 19th century. This creates an externality of inequality that the current market ignores. So within medicine their internally lies a stratification of the distribution of wealth and opportunity due to variables that are not accounted for through the neoclassical market theory of self-regulation.

Furthermore, the approach to solving this issue is derived from a non-laissez-faire perspective, involving government policy and intervention to hold hospitals accountable for how they have treated their women physicians. One of the many proposed solutions will be to educate and promote the “awareness in doctors” with respect to the gender biases, gender-role ideology and gender blindness that women are exposed to in the medical field.1 The hope is that with early intervention, the issue we currently face with discrimination will have been only of historical context in the near future. The benefit that is produced from abolishing gender prejudices, in medicine, is that patients of any gender will feel comfortable coming to their primary care-provider for a non-biased, non-discriminatory medicinal discussion for their health and well-being. Also, the industry of medicine will have a well-balanced field of competent men and women physicians ready to serve a diverse group of patients.

Income Inequality of Physicians by Sex

Income inequality is something that America has been struggling with over the past couple of centuries. From the Industrial revolution to the end of the three wars, the US economy and government have failed to account for income inequality which has affected our growth as a nation. In the medical industry, women have experienced tremendous increases in medical school acceptance and graduation, which can be seen in figure 1. With this great influx of women into the field, one would expect equality to go up, however, inequality and discrimination have risen in the past 50 years.

Income inequality between male and female physicians is a recurring issue that hasn’t yet been dealt with in a positive manner by our government. Instead, government officials are making the issue for women to earn higher salaries more of an obstacle. Donald Trump recently passed a bill making employer transparency in employee salary negotiation opaque. This will prevent women from negotiating their salaries with their employers.

In the past decade, the amount of women that graduated from medical school went down, which entails that women are more reluctant to enter medical school. The Center of Health Workshop Studies (CHWS) found that over the past decade the differences in income between men and women physicians have gone up by more than 100% (figure 2). This striking result is only a product of the institutional discrimination that women face in the medical field.

The values from figure 2 were starting salaries of physicians and they controlled for many variable factors that many would rebuttal against such as: patient care hours, specialty, setting and practice location. Many people argue that men make more than women because women see less patients than men due to home burdens like children and housework. This is absolutely true and need not be forgotten when taking into consideration the discrepancy in income. This fact would have solid arity, however hospitals are paying women less by the hour also. Vox found that women are paid less than men by 40% by the hour.

For example, if a woman and man, both with the same qualifications were interviewed, the male would make about $80/hour while the female physician would make roughly $32/hour. This cannot persist any longer and the government needs to intervene in such a way that alleviates this stratification in income. The separation pulls women more toward the lower middle class while men are pulled upward toward the upper class. This is important because if women continue to experience such inequality, they will stop attending medical school which will decrease the amount of women physicians available to patients. Female patients need support and advocacy in medicine because male physicians cannot relate to many physiological changes that women face. Indeed it is absolutely necessary to have an equal proportion of both sexes in medicine.

The result of such asymmetry will be missed diagnoses and increased prevalence of chronic illnesses (figure 3 (A and B)).5 For hospitals, preventative care is cheaper than treating a chronic illness, therefore, hospitals are destroying their revenue by not paying their female physicians the same as their male physicians. The ideology does not seem to resonate in anyway; in other words, none of this makes sense. Why would hospitals risk their income, to keep women at lower salaries? Although despicable, this is no novelty in America. Women have been disenfranchised and held down by the glass ceiling that corporations created to withhold the idea that men are superior to women. This toxic way of thinking has trickled over to employers when making decisions regarding who gets the promotion and who does not.

Harassment of Women Physicians

A notable tool that is used in society and hospitals to discriminate against women, is harassment. Females experience a great amount of harassment throughout their career which has caused many to seek alternative opportunities. A group of researchers discovered a striking result from a study, looking at the prevalence of harassment that female physicians experience by male patients. They conducted a survey to test the dependent variable which was measured as the percentage of occurrences such as inappropriate gifts, grabbing, sexual remarks/gestures, inappropriate touching and etc.6 The results from such study is shown in figure

Over 50% of the female physicians experienced either suggestive looks by patients or sexual remarks. Due to the subjectivity of these two categories, they aren’t as striking as some of the other findings. What’s worthy of discussion is the fact that about 20% of the female physicians were grabbed, touched or even brushed in inappropriate ways. The most striking finding was that about 1% of the women were even raped at least once throughout their career. This is rather frightening and just utterly shameful. Hospitals have done a poor job at protecting their female physicians, partly due to the fact that they would rather them not be there in the first place. Many will argue that women face harassment no matter where they work; whether it be in manufacturing, retail, business and/or medicine.

The notion is highly subject to invalidation because a recent study was published in 2005 concerning the higher than average rate of suicide by female physicians compared to females that are not (figure 5).7 It was concluded that the increased prevalence of suicide is inflated by the abnormal rate of harassment that female physicians face. It can be implied that females face higher risks in medicine than do males, however they are not compensated for such risks. Also, although women experience great discrimination in medicine, they’re numbers are still higher than ever before. One main concern for the future is, with the increase in women in medicine, will the suicidal rate for women go up. If alarming to the public, hospitals may have no choice but to accommodate; resulting in policy change and wage increase.

Optimally for patients, it would be ideal for there to be a normal distribution of female and male doctors per specialty. However, this is not the case (Table 1). It has been found that female physicians are more likely to enter specialties such as internal medicine and pediatrics, while men enter the more intense specialties such as surgery and radiology.8 This has caused an asymmetry in the distribution of doctors in medicine which has caused many of the missed diagnosis’s that were mention earlier. It is of no novelty that many people believe that surgery and other intense specialties are not for women. A recent study found that 59% and 68% of male and female medical school subjects, respectively, felt that surgery was not a career welcoming for women.9 Many reasons for this presumption is the lack of women faculty in medicine, hospital perceptions of women (ran by men), and hidden curricula during medical school years.