What determines the income gap between French male and female GPs - the role of medical practices

Abstract

BackgroundIn many OECD countries, the gender differences in physicians’ pay favour male doctors. Due to the feminisation of the doctor profession, it is essential to measure this income gap in the French context of Fee-for-service payment (FFS) and then to precisely identify its determinants. The objective of this study is to measure and analyse the 2008 income gap between males and females general practitioners (GPs). This paper focuses on the role of gender medical practices differentials among GPs working in private practice in the southwest region of France.MethodsUsing data from 339 private-practice GPs, we measured an average gender income gap of approximately 26% in favour of men. Using the decomposition method, we examined the factors that could explain gender disparities in income.ResultsThe analysis showed that 73% of the income gap can be explained by the average differences in doctors’ characteristics; for example, 61% of the gender income gap is explained by the gender differences in workload, i.e., number of consultations and visits, which is on average significantly lower for female GPs than for male GPs. Furthermore, the decomposition method allowed us to highlight the differences in the marginal returns of doctors’ characteristics and variables contributing to income, such as GP workload; we found that female GPs have a higher marginal return in terms of earnings when performing an additional medical service.ConclusionsThe findings of this study help to understand the determinants of the income gap between male and female GPs. Even though workload is clearly an essential determinant of income, FFS does not reduce the gender income gap, and there is an imperfect relationship between the provision of medical services and income. In the context of feminisation, it appears that female GPs receive a lower income but attain higher marginal returns when performing an additional consultation.

Income inequality among general practitioners in Iran: a decomposition approach

“…Homaie Rad et al without mentioning the reasons for income inequality among different gender groups, pointed out that there was a significant difference between the income of women and men employed in the health sector of Iran [5]. Several studies, which are consistent with the results of the present study, have identified the main cause of income inequality among male and female GPs in their working hours [16, 17, 25, 26]. Nevertheless, the results of Duckett’s study in the United States, which contradict the interpretation of the results of the present study, showed that, apart from other factors such as working hours, there is a significant difference between the income of female and male employees in the health sector.…”

“…A study in Australia showed that GPs who worked in outer regions or rural areas and those who worked in personal office had higher income [16]. Another study in France demonstrated that male GPs had higher income than females, this result was explained with respect to different workloads [17].…”

The implications of the feminization of the primary care physician workforce on service supply: a systematic review

“…The primary care physician (PCP) workforce in many industrialized nations is increasingly female. In several industrialized countries, the proportion of PCPs who are women has doubled or nearly doubled over the last 30 years [ 1 , 2 ]. Globally, 32% of all physician graduates worldwide are female, and that percentage is higher, on average, in family medicine [ 3 ].…”

Differences in Practice Characteristics Between Male and Female Chiropractors in Switzerland

“…1 This discrepancy in workload between the sexes identified in this study on chiropractic medicine in Switzerland has been described in other medical professions in the same way and is consistent with the study mentioned earlier about the situation in other countries relating to the ongoing feminization in medicine. 16,17 It is most likely caused by the higher number of female doctors working part time compared with their male counterparts. 9,10 As mentioned earlier, for female doctors, working part time seems to have a negative influence on their career.…”

“…11 These same trends are also occurring in other countries, with women physicians more likely to work part time and participate in group practices. [8][9][10][16][17][18][19] Because there is an obvious majority of female students currently studying chiropractic medicine at the University of Zürich, similar to their medical counterparts, it is important to know what effect, if any, this will have for patients and their chiropractic care in the future. Therefore, the purpose of this study is to identify differences in the practice characteristics and treatment techniques of female and male chiropractors and to discuss what impact these differences might have for the profession in the coming years.…”