White doctors earn more money than black physicians, study finds

The disparity in pay between blacks and whites has been well documented over the years, with sociologists imputing everything from systemic discrimination to differences in education and employment expectations for the inequality in paychecks.

Anupam B. Jena, MD, PhD, an associate professor at Harvard Medical School, wondered if the same sort of wage gap exists between black and white doctors. Jena teamed with researchers from Harvard and the University of Southern California to study race and employment data from two nationally representative surveys to determine the answer.

Their findings were alarming.

“The biggest takeaway from the study is that, despite the uniform education levels and credentials among all doctors, white male physicians earn substantively more than black male physicians even when one accounts for factors such as specialty, work hours, practice type, patient insurance mix, and geography,” Jena says.

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However, the study wasn’t able to identify the specific factors that led to higher incomes among white versus black male physicians.

“We know that specialty decisions differ-white physicians are more likely to be in higher paying specialties-but it remains to be understood whether these differences reflect varying preferences or varying access to high-paying specialties,” Jena says. “If the latter is occurring, that is an important issue that needs to be addressed. Other factors to consider involve differences in negotiating leverage, overt labor market discrimination, and differences in types of services performed.”

Peter McHenry, M.A., an assistant professor of economics and public policy at the College of William & Mary, calculated compensation differences with a different study on the topic-the 2014 American Community Survey,-and confirmed Jena’s study that black physicians earn less on average and at the median than white physicians.  

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“This is true for wage and salary income and also for a total income measure that adds business income to wage and salary income,” he says. “When I looked at the 2014 data, I noticed smaller wage gaps for younger physicians. The [Harvard] study focuses on physicians aged 35 and over. The racial wage gap might widen over physicians’ careers, or the gap might be closing over time.”

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Lisa Ashe, DO, medical director for healthcare provider group Be Well Medical, Alexandria, Va., says social isolation from white colleagues and lack of African-American mentors are commonplace in medicine. In addition, she believes there’s still a significant amount of racial discrimination in the profession, which makes finding and maintaining employment difficult.

Ashe feels there should be stricter standards in place that include minimum salaries and benefits for each specialty and job type, and medical schools and residencies should offer more salary and negotiating tips for graduates.

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Adia Harvey Wingfield, PhD, a sociologist and professor at Washington State University who studies issues that minority doctors face in the workplace, says that black doctors are particularly committed to working in the public sector to address the healthcare needs of underserved populations, which often leaves them vulnerable to salary disparities that characterize public sector work. 

Wingfield believes that increasing the numbers of blacks in medicine would be an important step in improving the situation, and it all starts with education. In her mind, there’s a need to expose more black youth to programs designed to inculcate an interest in healthcare professions, a greater emphasis needed to call out the importance of diversity in the field, and parameters in place to help to control higher education costs.

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Reversing the inequality also involves admitting that the problem exists. Jena notes that qualitative analyses could shed light on why these differences exist and whether, in fact, African-Americans face barriers to certain high-paying specialties and jobs.

“A number of state medical schools also report salary information publicly,” he says. “That information could be used for the purpose of salary transparency, to ensure that fair compensation is provided to physicians conditional on their research and clinical productivity.”

Next: “Black male doctors cope with a phenomenon I describe as ‘partial tokenization’"

The Harvard report also shows that pay gaps between male and female physicians tend to be substantially larger than differences by race or ethnicity but there isn’t much difference in compensation between black and white female physicians.

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“Black male doctors cope with a phenomenon I describe as ‘partial tokenization,’ where race makes them outsiders in the predominantly white world of medicine, but gender provides them with advantages that elude their female counterparts,” Wingfield says. “At times, they still encounter racial stereotypes from patients and/or colleagues, but see themselves having an easier time adjusting to the medical profession than female peers of all races who must navigate gender biases. Black women in this field cope with cultural assumptions that women should be nurses, not doctors, along with racial stereotypes of black inferiority.”