I found a good example of this on Twitter the other day. Harvard sent out the following tweet:
Study provides strong evidence that female physicians are underpaid compared to their male counterparts http://t.co/KywpgWb7kEWell doesn’t that sound awful? Speaking for myself (and likely the rest of the human race) I don’t particularly care about the gender of the physician who is working on me. My preference is for a competent and skilled medical practitioner. When the general populace hears something like this-- and when it comes from the nation’s most prestigious institution of learning-- it carries quite a bit of weight.
— Harvard University (@Harvard) September 10, 2013
Trouble is, when one digs into the article we find this bit of information near the end:
“While it is important to study gender differences in earnings after accounting for factors such as specialty choice and practice type, it is equally important to understand overall unadjusted gender differences in earnings. We performed the latter study,” he writes. “This is because specialty and practice choices may be due to not only preferences of female physicians but also unequal opportunities. For example, are unadjusted earnings differences between male and female physicians due to a preference of female physicians for lower-paying specialties [pediatrics or primary care] or do female physicians have less opportunity to enter higher-paying specialties despite having similar preferences as male physicians? The etiology of the persistent gender gap in physician earnings is unknown and merits further consideration.”
Notice how the researcher blocks the real cause-- the choice of female doctors to go into lower paying specialties-- around what they were trying to find: gender bias.
Also notice the researcher does not mention something that takes a big bite out of physician’s earnings: malpractice insurance. This is a big mistake because many physicians pay massive amounts of their income to the insurance companies so they will not lose their practice if they are sued for malpractice. Certain lawsuits tend to be much larger than others. If one makes a mistake that causes a major injury or death to a child, there is likely to be a huge settlement. Since there is much greater risk, the physician is required to pay quite a bit more in malpractice insurance, which lowers take home pay. (Without going onto a tangent, this is a massive reason why healthcare is so expensive and if we had tort reform in Obamacare we might be seeing better care for less cost today, instead of things going in the opposite direction.)
Given that women tend to enjoy going into pediatrics or OB/GYN, two specialties where malpractice lawsuits can easily reach seven figure settlements, we have found a big part of the answer as to why women doctors tend to make less than men.
I also wonder if part of the rest of the pay gap comes from men simply deciding to charge higher rates. Some people are better at negotiating than others and it’s possible that men as a gender are more willing to gamble on negotiating higher rates than females. This is not something I have any evidence of, but it’s something I would like to see the study address. People who ask for more tend to get a little more, and even if they don’t get much it still sets the stage for future increases. An extra $5000 a year is not so much to someone making $250,000, but when one gets used to negotiation over time that difference can add up.
Still, the primary bias in the medical field is not gender based but based on selection. When someone goes out with a certain end result in mind, it becomes too easy to end up at that result. If we have studies that fail to address alternate reasoning with anything more than a dismissive hand wave it is not beneficial to the women the group is trying to assist.
