Abstract
Background: Male medical student interest in the field of obstetrics-gynecology has
significantly decreased in the last three decades. A perceived patient preference for female obstetrician-
gynecologists (Ob-Gyn) and subsequent gender differences in clinical productivity and compensation
may influence this trend.
Objective: To explore how provider gender affects clinical productivity and salary among obstetrics-
gynecology generalists.
Methods: An analysis of productivity and salary data for generalist Ob-Gyns employed by an academic
integrated health system was performed. Gross charges, net collections, physician payroll
information, work relative value units (wRVUs), new and existing patient encounter volumes and
clinical full-time equivalent (FTE) status were compared year over year by physician gender using a
repeated measures ANOVA test.
Results: On average, male providers earned a numerically higher salary in each year studied,
but when the entire timeframe was evaluated, there was no significant difference in salary nor
total productivity between women and men (p=0.19 and 0.15, respectively). There was a gender
difference in how total productivity was achieved, with women seeing twice as many new patients
(p= 0.0025), and men achieving higher average wRVUs per patient encounter (p=0.02).
Conclusions: There was no significant difference in total productivity and there was no significant
difference in salaries between male and female Ob-Gyns. However, there were differences in the
type of care that contributed to productivity by gender. Female providers saw a higher proportion of
new patient encounters, while male providers accrued a higher wRVU per encounter, likely as a
result of higher procedure volumes. These findings are an encouraging sign that men are not disadvantaged
in terms of productivity in obstetrics-gynecology and that compensation models such as
the one in this system can promote fair payment in mixed-gender physician groups.
Keywords:
Gender, productivity, compensation, obstetrician, gynecologist, salary data.
Graphical Abstract
[1]
Gerber SE, Lo Sasso AT. The evolving gender gap in general obstetrics and gynecology. Am J Obstet Gynecol 2006; 195: 1427-30.
[2]
Rayburn WL. The Obstetrician-Gynecologist Workforce in the United States: Facts, Figures, and Implications 2017. Washington D.C. The American Congress of Obstetricians and Gynecologists 2017.
[4]
Baron JN, Newman AE. For what it’s worth: Organizations, occupations and the value of work done by women and non-Whites. Am Sociol Rev 1990; 55: 155-75.
[5]
Steinberg RJ. Comparable Worth in Gender Studies In: Smelser
NJ, Baltes PB, Eds International Encyclopedia of the Social Behavioral
Sciences Vol 4 Cambridge University Press: Oxford:
2001: pp 2393-7 .
[6]
Sorensen E. Comparable Worth: Is It a Worthy Policy?. Princeton, NJ: Princeton University Press 1994.
[7]
Levanon A, England P, Allison P. Occupational feminization and pay: assessing causal dynamics using 1950-2000 US Census data. Soc Forces 2009; 88(2): 865-92.
[8]
Schnuth RL, Vasilenko P, Mavis B, Marshall J. What influences medical students to pursue careers in obstetrics and gynecology? Am J Obstet Gynecol 2003; 189: 639-43.
[9]
Racz JM, Srikanthan A, Hahn PM, Reid RL. Gender preference for a female physician diminishes as women have increased experience with intimate examinations. J Obstet Gynaecol Can 2008; 30(10): 910-7.
[10]
Kincheloe LR. Gender bias against male obstetrician gynecologists in Women’s magazines. Obstet Gynaecol 2004; 104(5): 1089-93.
[11]
Plunkett BA, Kohli P, Milad MP. The importance of physician gender in the selection of an obstetrician or a gynecologist. Am J Obstet Gynecol 2002; 186(5): 926-8.
[12]
Johnson AM, Schnatz PF, Kelsey AM, Ohannessian CM. Do women prefer care from female or male obstetrician-gynecologists? A study of patient gender preference. J Am Osteopath Assoc 2005; 105(8): 369-79.
[13]
Hammoud MM, Stansfield RB, Katz NT, Dugoff L, McCarthy J, White CB. The effect of the obstetrics and gynecology clerkship on students’ interest in a career in obstetrics and gynecology. Am J Obstet Gynecol 2006; 195: 1422-6.
[14]
Gariti DL, Zollinger TW, Look KY. Factors detracting students from applying for an obstetrics and gynecology residency. Am J Obstet Gynecol 2005; 193: 289-93.
[15]
Chang JC, Odrobina MR, McIntyre-Seltman K. Residents as role models: The effect of the obstetrics and gynecology clerkship on medical students’ career interest. J Grad Med Educ 2010; 2: 341-5.
[16]
Spencer ES, Deal AM, Pruthi NR, et al. Gender differences in compensation, job satisfaction and other practice patterns in urology. J Urol 2016; 195(2): 450-5.
[21]
Jena AB, Olenski AR, Blumenthal DM. Sex differences in physician salary in US Public Medical Schools. JAMA Intern Med 2016; 176(9): 1294-304.
[22]
Jagsi R, Griffith KA, Stewart A, Sambuco D, De Castro R, Ubel PA. Gender differences in the salaries of physician researchers. JAMA 2012; 307(22): 2410-7.
[24]
Physician Compensation and Production Survey: 2014 report based on 2013 data Englewood, CO MGMA. 2014.