Background Women are becoming doctors in greater numbers. Despite this, there is evidence of female doctors’ continued differential treatment compared to their male counterparts. Purpose The aim of this study was to review systematically the extant literature on the gender-based pay gap in medicine across time, different medical specialties, and different countries of clinical practice. Methods Systematic search of three databases using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies needed to be empirical and contain either an unadjusted or adjusted gender-based finding related to pay. Results A total of 46 articles published since 2000 contained a gender-based finding related to physician pay. Thirty-two of these 46 articles presented either adjusted or unadjusted means comparisons (or both) comparing pay between male and female physicians. Eighteen of the 46 articles controlled for one or more variables in examining pay between the two groups. Across almost all studies, female doctors earn significantly less than men, often tens of thousands of dollars less annually, despite similar demographic and work-related profiles. This earnings gap is persistent across time, medical specialty, and country of practice. Practice Implications The gender-based pay gap is an ongoing crisis within medicine that must be addressed. From a practice perspective, women physicians may benefit from greater organizational awareness of potential workplace bias and the implementation of more supportive policies aimed at better equalizing compensation through greater support and transparency related to salary negotiations, promotional opportunities, and pay scales across various job titles.
Purpose Physicians work increasingly in larger organizations across different health care delivery systems. This systematic review examines the published empirical literature on organizational commitment among physicians within an international context. Design A systematic, PRISMA-guided review examining studies of organizational commitment among physicians published over time. Four article databases and a combination of appropriate search terms aided in identifying relevant articles. Findings Key findings include: (a) physicians, regardless of country, personal characteristics, type of job, or place of employment generally have lower levels of organizational commitment than other health care workers; (b) work- and job-related variables, particular age and job satisfaction, shape physicians’ organizational commitment; and (c) organizational commitment and the factors that shape it are similar across physicians working in different health systems. Review implications: Organizational commitment should remain central for researchers to study in most health systems internationally. Larger samples, longitudinal research, and greater use of theory are design improvements that will strengthen the extant research. The findings imply that if healthcare organizations create workplaces that make physicians feel in control, do not overwhelm them with work, provide a supportive culture, enhance their ability to give input, and keep them job satisfied, they may gain enhanced organizational commitment. Originality and value: To our knowledge, this is the first review of research examining organizational commitment among physicians. It is a resource for researchers and managers interested in learning more about aligning physician thinking and behavior with health care organizations.
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