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Female Doctors Are Spending More Time With Patients, But Earning Less Money

female doctor showing ipad to patients

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Key Takeaways

  • A new study finds female primary care physicians (PCPs) spend more time with their patients than male doctors, which is contributing to the gender pay gap among physicians.
  •  Some female PCPs were not surprised by the study’s results, which found women doctors spend an extra 2.4 minutes with their patients compared to their male counterparts.
  •  Paying doctors by visit seems to be contributing to the wage gap, the study’s authors say.

For years, it’s been widely known that female doctors tend to make less money than their male counterparts, but now, according to a new study, it's becoming clear the reason behind that pay gap isn’t because they work fewer hours.

The study, published in the New England Journal of Medicine, suggests the pay gap is a result of female doctors spending more time with their patients in face-to-face visits than male doctors, and as a result, seeing fewer patients throughout the year. 

“The main results of the paper are that female doctors earned 11% less visit-revenue per year on account of doing 11% fewer visits per year, but they spent more time with patients per visit, per day and per year,” first author Ishani Ganguli, MD, MPH, a health policy researcher and assistant professor at Harvard Medical School and Brigham & Women’s Hospital Division of General Internal Medicine and Primary Care, in Boston, Massachusetts, tells Verywell.  

Ganguli and her colleagues found that, on average, female primary care physicians spend an extra 2.4 minutes with their patients per visit. Although that may not sound like a lot of time, over the course of a year, that adds up to about 20 additional hours spent with patients.

The study also found female physicians reported a larger number of diagnoses and ordered more follow-up exams and prescriptions, yet they often missed the opportunity to use higher-paying billing codes on the basis of visit duration.

To come to these conclusions, the study’s authors analyzed data from billing claims and electronic health records of over 24 million primary care office visits in 2017. 

The samples accounted for factors like the physician's age, degree, specialty, and number of scheduled sessions per day or week—as well as characteristics of the patients, including age, gender, race or ethnic group, marital status, number of chronic conditions, primary insurer, and whether the person was new to the doctor.

Another striking result of the study, Ganguli says, is how much the way doctors get paid (by volume) affects gender equity.

“There're many examples of why this (paying for volume system) doesn’t work, one is [that] it rewards doctors for sort of rushing through visits, [and] it rewards doctors for bringing patients back in for visits when maybe a phone call or something else would be enough,” Ganguli says. “The idea that women and men react differently to these incentives is yet another nail in the coffin for volume-based payment."

What This Means For You

Although not all doctors are created equal, this study suggests that female doctors may spend more time with you during an office visit and order more follow-up exams and treatments. The research also adds to growing literature that the pay-for-volume system for physicians is contributing to the well-known pay gap between male and female PCPs.

Although more research would need to be done to figure out if other methods of payments for doctors would help solve this gender pay gap—like paying doctors by salaries, which some healthcare systems currently do—Hannah Neprash, the study co-lead and an assistant professor at the University of Minnesota's School of Public Health, says some healthcare leaders are already working on better solutions. 

“The good news is that there are many efforts to transition away from volume-based payment," Neprash tells Verywell. "Instead of paying clinicians for each service they provide, reforms may emphasize paying for higher quality care, better outcomes, and/or the size and characteristics of physicians’ overall patient panels."

How Does This Affect Patient Care?

It’s easy to understand why spending more time with your doctor for a general wellness check-up has its benefits: for starters, you’re able to get out all of your questions without feeling like you’re being rushed out the door. And physicians agree that there are a number of benefits to devoting extra time to their patients. 

Keri Peterson, MD, a primary care physician in New York City and a specialist in internal medicine, tells Verywell that it's extremely important to make a connection with her patients by asking more questions and getting to know them.

“That effort creates trust and meaning in the relationship. But this does take more time," Peterson says. "In the long run, it is worth it, since patients are very loyal to a doctor that they feel safe and comfortable with taking care of them."

Asking extra questions is also a way doctors can discover underlying health issues going on with their patients. Dana S. Simpler, MD, a general practitioner who owns her own private practice in Baltimore, Maryland, says she wasn’t surprised to learn about the study’s findings, and explains that probing her patients for more information has helped her make the right diagnosis in many cases. 

“It takes time to drill down and get to know what’s really potentially causing the problem—and when you take the little extra time, you can find these things that are the real culprit of the problem,” Simpler tells Verywell. 

Although the study didn’t dive into the specifics on exactly why women tend to spend more time with their patients, Peterson points to the types of relationships women have with others. 

“Perhaps female doctors feel the need to create a deeper connection based on how we interact with other people in our lives: our friends, spouses, and loved ones,” Peterson says.

Ganguli also says that the link may come from the differences in women’s interpersonal skills or how they’re typically raised to respond to people. 

 

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  1. Ly Dan P, Seabury Seth A, Jena Anupam B. Differences in incomes of physicians in the United States by race and sex: observational studyBMJ 2016; 353 :i2923. doi:10.1136/bmj.i2923 

  2. Ganguli I, Sheridan B, Gray J, Chernew M, Rosenthal MB, Neprash H. Physician work hours and the gender pay gap — evidence from primary careN Engl J Med. 2020;383(14):1349-1357. doi:10.1056/NEJMsa2013804

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