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Observational Study
. 2016 Jun 7:353:i2923.
doi: 10.1136/bmj.i2923.

Differences in incomes of physicians in the United States by race and sex: observational study

Dan P Ly  1 , Seth A Seabury  2 , Anupam B Jena  3
Affiliations
Observational Study

Differences in incomes of physicians in the United States by race and sex: observational study

Dan P Ly et al. BMJ. .

Abstract

Objectives: To estimate differences in annual income of physicians in the United States by race and sex adjusted for characteristics of physicians and practices.

Design: Cross sectional survey study.

Setting: Nationally representative samples of US physicians.

Participants: The 2000-13 American Community Survey (ACS) included 43 213 white male, 1698 black male, 15 164 white female, and 1252 black female physicians. The 2000-08 Center for Studying Health System Change (HSC) physician surveys included 12 843 white male, 518 black male, 3880 white female, and 342 black female physicians.

Main outcome measures: Annual income adjusted for age, hours worked, time period, and state of residence (from ACS data). Income was adjusted for age, specialty, hours worked, time period, years in practice, practice type, and percentage of revenue from Medicare/Medicaid (from HSC physician surveys).

Results: White male physicians had a higher median annual income than black male physicians, whereas race was not consistently associated with median income among female physicians. For example, in 2010-13 in the ACS, white male physicians had an adjusted median annual income of $253 042 (95% confidence interval $248 670 to $257 413) compared with $188 230 ($170 844 to $205 616) for black male physicians (difference $64 812; P<0.001). White female physicians had an adjusted median annual income of $163 234 ($159 912 to 166 557) compared with $152 784 ($137 927 to $167 641) for black female physicians (difference $10 450; P=0.17). $100 000 is currently equivalent to about £69 000 (€89 000). Patterns were unaffected by adjustment for specialty and characteristics of practice in the HSC physician surveys.

Conclusions: White male physicians earn substantially more than black male physicians, after adjustment for characteristics of physicians and practices, while white and black female physicians earn similar incomes to each other, but significantly less than their male counterparts. Whether these differences reflect disparities in job opportunities is important to determine.

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Conflict of interest statement

Contributors: All authors contributed to the design and conduct of the study; data collection and management; analysis and interpretation of the data; and preparation, review, or approval of the manuscript. ABJ is guarantor.

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work

Figures

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Fig 1 Trends in adjusted annual median income of US physicians in American Community Survey, by race-sex subgroup, 2000-13. Adjusted earned incomes are predicted values from multivariable median regression of annual employment income as function of age (35-39, 40-49, 50-59, and ≥60), sex, race, hours worked (≤39, 40-49, 50-59, and ≥60 hours), time period, state fixed effects, and full interactions between race, sex, and time period. All $ values normalized to 2013 $ according to consumer price index
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Fig 2 Income distribution of US physicians in HSC physician surveys (2000-01, 2004-05, 2008) by race and sex. Adjusted income categories predicted categories from multivariable ordered logit regression of net income from practice of medicine as function of age (35-39, 40-49, 50-59, and ≥60) and hours worked (≤39, 40-49, 50-59, and ≥60 hours), chosen to replicate similar adjustment variables from the ACS analysis. All $ values normalized to 2008 $ according to consumer price index
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Fig 3 Income distribution of US physicians in HSC physician surveys (2000-01, 2004-05, 2008) by race and sex. Adjusted as for fig 2 plus adjustments for years in practice, practice type, percentage revenue from Medicare, percentage revenue from Medicaid, and specialty type. All $ values normalized to 2008 $ according to consumer price index
See this image and copyright information in PMC

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