Gender Inequalities in The Medical Field

By: Isabella Martino

Mrs. D. Oliveira
WRT 104
1 March 2020

Gender Inequalities in The Medical Field

 Gender Inequalities in the Medical Field 1

Introduction

Medicine, like many aspects of society, continues to experience rapid development.

Extensive research causes cutting edge breakthroughs as scientists: answer critical questions,

discover cures for diseases, and produce advanced drugs. Ultimately, modern medicine has

evolved greatly since its early beginnings. If such drastic benefits have surfaced in medicine,

ideas never dreamed possible in some cases, I believe hope exists for equality for genders. By the

end of my research, I expect to fully understand all issues surrounding gender inequalities, in

their entirety and learn the importance of progress made, if any, toward gender equality. For my

Senior Exhibition project, from February 3, 2020, through to the end of the semester, I intern at a

dermatology office to learn how to run and operate a high functioning medical office. I plan to

spend my time working with administrators, nurses, and the physician to understand how each

role serves an important purpose to keep the office on an upward trajectory. For the research

component of my project, the essential question driving my research is, “If it exists, how does

gender inequality affect those in the medical workforce?” Other considerations driving my

research include: if and how multiculturalism affects inequality; how people currently work to

close pay gaps, and where else does gender inequality exist outside of the job force. With the

utilization of the pallet of perspectives, my research ideas broadened, allowing me to think

critically about this topic. My study ties directly to, not only my project, but it is also a reality I

must understand to complete my aspirations of working in the medical field. I chose this topic

because as a female myself, a crucial understanding of the dynamics of gender inequality will

help me to contribute to gender equality.

Literature Review
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In the 2019 article, “The Gender Pay Gap for Doctors Is Getting Worse. Here’s What

Women Make Compared to Men”', Health and Wellness reporter Jamie Ducharme explains the

current issue of the gender pay gap, specifically in the medical field. Ducharme focuses mainly

on the gender pay gap between males and females over the last year, while also pointing out

other factors that often occur. She begins by explaining how the actual monetary figure made by

females varies depending on their race, the industry they work in, and the geographic location in

which they work. Through her investigation, Ducharme concluded that women of color have an

even larger pay gap than white women as compared to males in the medical field. Ducharme

divulges statistics from Medscape’s 2019 report, which polled about 20,000 United States (U.S.)

doctors in 30 specialties. Her findings indicated that pay for physicians has risen by about 20%

for both primary care physicians and specialists since 2015. These increases, however, have not

been equal for male and female doctors. Although the salary for this field has risen, the amount

has not been the same for men and women. Ducharme questioned if the pay was equal even in

the first place, and discovered the answer is no. Statistics show that in 2018, male primary care

physicians earned 18% more than female counterparts. In 2019, the pay gap widened to 25%, as

the typical male doctor averaged $258,000 per year, while the typical female physician earned

$207,000 according to the report. The pay gap among specialists was even larger, to begin with,

but it narrowed slightly, from 36% in 2018 to 33% in 2019. The average salary for male

specialists is now $372,000, compared to $280,000 for female specialists. The reasoning for this

pay gap is called into question when looking at the difference in these numbers, so Ducharme

explains that on average, male physicians spend 9% more time with their patients. Female

doctors generally spend that extra time completing paperwork or other administrative tasks. This

information is important to note because a physician’s salary is supposed to be based on the

 Gender Inequalities in the Medical Field 3

number of patients they see. Ducharme also includes Medscape's report of 2019 that reveals

women in the medical field tend to acquire jobs with lower salaries such as those in primary care

medicine. Men, on the other hand, tend to have jobs in high-paying areas such as orthopedics,

plastic surgery, and cardiology. This observation depicts a reason why some men receive greater

pay than women in the medical field as a whole, but not for those in the same specific

occupations. In the recent viewpoint article about how to close the physician pay gap in ​an

international peer-reviewed general medical journal,​ ​JAMA​, also highlighted by Ducharme, Dr.

Maryam Asgari, an associate professor of dermatology at Harvard Medical School, explains that

although the same contract is given to both male and female doctors, the clinical support varies

between genders. Asgari, explained she, experienced situations where schedulers gave male

colleagues better-operating schedules that allowed them to see more patients and therefore

generate more revenue. To complete an education at the same level, receive a job under the same

title, and not receive the same benefits and treatment is not only unethical, but unjustifiable. The

pay gap is very relevant and by informing readers of these important issues, this article proves

inequality in the medical workforce exists. The author exemplifies the need for legislation to take

a thorough look at the occurrences of such gender inequalities and make changes to benefit those

impacted.

Author of CNN health article, “Women Have to Work Harder to Be Promoted”, Leonora

Risse, explains in-depth the issue of unequal treatment of male and female employees. The 2018

article begins with an anecdote explaining that it took a Nobel Prize before physicist Donna

Strickland was promoted to a full professorship. Evidence from real cases, such as Strickland’s

supports the fact women have to prove themselves even more than men to earn job promotions.

Until 2018, there was no way to directly compare men and women on the same “rung of the
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career ladder” or compare capabilities for the same job. By measuring productivity and

efficiency, however, Risse found women have up to one-and-a-half years of extra education and

almost a full year extra workforce experience than the requirements for their occupation. When

comparing the average employee to the most economical performers, Risse had discovered,

“those who have achieved their position with the lowest capabilities to their name -- I found

women ‘over-invest’ more than men in their skills and capabilities. Men over-invest by up to

4%. Women by up to 11% -- equivalent to a year-and-a-half extra education and nearly a full

year's extra workforce experience”, and when put into simpler terms women have been found to

do more, but receive less in pay. The over-investment, not due to children and care

responsibilities or women’s lower confidence. Risse developed the “achievement motivation”

variable which tested factors that caused the evidence of greater accumulation of credentials.

Data has proven women earn less from their university degrees compared to men especially in

areas of law, economics, dentistry, and medicine. The workplace created an unfair labor practice

for women in multiple ways. One example involves the dynamics of the workplace that creates

“higher hurdles for women to clear along the career ladder”, as described by Risse. When

women ask for a promotion, they too often receive answers that differ from that of the answer

given to a man. A man possibly with less qualification may find themselves landing the position

over their female counterpart when asking for a promotion. This issue sets the organization at a

disadvantage by not realizing each person's capability. A change must arise to ensure the

assessment of each individual’s merits is done in an impartial fashion. Another dispute that

requires alterations to eliminate inequality in the workplace.

Issues that contribute to the gender pay gap and inequality also stem from lifestyle

decisions. In her 2019 article, “Female Doctors Are More Likely to Go Part-Time” lifestyle
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writer Meera Jagannathan, cites recent studies regarding females in medical practices who tend

to make the difficult decision to work a part-time position, rather than full time. The study found

this decision only occurred for females who worked part-time or not at all following medical

training, as opposed to their male peers. A 2016 study cited analyzed data from 344 physicians,

just over half of whom were women, that:

The authors found that female doctors were far more likely than their male counterparts

to not be working full-time (22.6 percent versus 3.6 percent), with a clear disparity

between women with kids and men with kids (30.6 percent versus 4.6 percent). In the

first year after medical training, men and women had a 9.6 percentage-point gap in their

full-time employment — but that gender gap stretched to 38.7 points at six years

post-training.

Jagannathan explains the common occurrences of a woman choosing to put family overwork.

The reality for this decision suggests one of maternal obligation. In the article, Medical

University of South Carolina associate professor Constance Guille divulges stark differences in

the deciding factors for men’s and women's decisions to work full or part-time. For women, “the

major factor was child-care responsibilities, balancing work and family and children but the

balance becomes a difficult task, requiring sacrifices to be made. Men, on the other hand, claim,

“The big words that jump out are financial - need money, loans, I don't think you could even find

the word child on the man one”, while females are concerned about their duties as a mother, men

seem to focus on income. A major discrepancy exists between the reason for the number of

hours worked. The practice of medicine could offer a tremendous opportunity to create support

for its women and their families. Without a doubt, physicians, who are parents, require better

work support systems, which include work flexibility, on-site daycare, and paid parental leave. A
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cultural shift, however, has begun to occur in medical organizations in areas such as parental

leave. Men have access, just like women to this opportunity, but institutional culture pushes

males against actually taking it, despite the legitimacy of this policy. By the year 2032, the U.S.

expects to experience a shortage of between 46,900 and 121,900 physicians in both primary and

specialty care. The sudden decrease in full-time female physicians could worsen this grim

scenario. This prediction is not just due to leadership diversity in healthcare. The data from the

2018 study by the Proceedings of the National Academy of Science, attests that hospital patients,

treated by female doctors, are less likely than those treated by male doctors to die or be

readmitted within a month of discharge. The study also discovered, “female heart-attack patients

had better survival rates when treated by female doctors than by male doctors. Female patients’

mortality rates decreased when their male doctors had more female colleagues the research

found, and when they had more experience caring for female patients'', suggesting female

physicians tend to make a greater difference than realized, and due to their compassion. Doctors

play a crucial factor in the lives of all people. This article reveals the need to support all doctors

with work-life balance, but especially females with children, to help them find work-life balance.

With a threat of shortages in physicians over the next decade, vigorous work must be encouraged

to find a solution.

A work-life imbalance has other implications as well. Each person has their own identity

out of the office, in order to maintain a healthy workplace environment, the importance of

equality must also be considered. The 2018 article “Gender Inequality and Women in the

Workplace '' article by Mary Brinton, allows insight into data and personal experiences. As a

sociology professor at Harvard and a female, Brinton knows the topic well. Brinton begins by

explaining the matter of education. Studies have found that, in terms of education, women have
 Gender Inequalities in the Medical Field 7

caught up to men as “in the United States and a number of other countries, women now actually

surpass men in educational achievement”, suggesting that, major strides have occurred for

women. For instance, Brinton describes Japan as a demographic time bomb,

Japanese women are getting more education and want to have a career. But within the

home, gender equality is not on pace with workforce equality. Women end up doing a

‘second shift' of housework and childcare when they return home from work… women

are waiting longer to get into a partnership...choosing, instead, to focus on their career...

so there is no doubt that this issue occurs within other cultures. The issue of female obligation

toward, for instance, household activities, plays a factor in setting women at a disadvantage in

the workplace as “It is unrealistic to expect gender equality if workplaces demand that women

are available all the time” and so, elimination of inequality becomes impossible. A substantial

portion of the article was also dedicated to the steady decline in fertility rates around the world.

A birth rate of 2.1 is necessary for a country to replace its population and “ In the United States,

the fertility rate is 1.9. In Southern Europe and East Asia, rates are now below 1.3” and the

author believes inequality in the workplace is partially at blame for these declining numbers. A

need for concern is created as “Japan’s population is projected to drop by one-sixth by 2020, and

by 2025… This means skyrocketing health care and pension costs as the population ages. The

reduced number of young, homegrown workers entering the workforce and paying into the

pension systems could undermine Japan’s economy”, indicating that a declining population

harms all areas of a society for the worse. Countries such as Japan hold very high standards for

their female population with, “The cultural emphasis on being the ideal mother, along with a

corporate culture that demands long work hours, makes motherhood very difficult for women

with careers” as the balance between work and home becomes a struggle causing women to pick
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one or the other. For Brinton, declining fertility rates are a substantial focus in her research, and

thorough investigation, she found that workplace stereotypes have been to blame. Gender

stereotypes in the workplace that developed seem close to impossible to break, and no matter the

gender, people face or engage in stereotypes at one point or another. Society must encourage

those who break stereotypes and recognize the contributions that each individual, male or

female, can make to the workplace and to relationships at home. New standards must be created

if those standards of the past cannot be dismembered.

Within the workplace, the unfair treatment also becomes a topic-focused not just on

unequal pay, but that of how women are viewed and addressed in the workplace. In her 2019

article, “Has Sexual Harassment at Work Decreased Since #MeToo?”, professor of management

and author, Stefanie K. Johnson elaborates on her findings of changes seen around the office

since the “#MeToo” movement. Introduced in 2017, #MeToo gained popularity following the

Harvey Weinstein sexual abuse allegations. Two years after the introduction of the hashtag,

many people still have questions surrounding the topic of sexual harassment within the

workplace. Johnson’s data collection began in 2016, prior to the movement. Her data involved

250 working women in the United States who answered questions pertaining to sexual

harassment within their workplaces and the impact it has on their jobs. In the second survey

conducted in 2018, 263 women were asked the same questions, some of whom had answered in

the first survey. Measured in three dimensions, sexual harassment was broken down into gender

harassment, unwanted sexual attention, and sexual coercion. Gender harassment, as defined in

the article, involves negative treatment of women, not necessarily sexual, but including a

supervisor or coworker making sexist remarks, telling inappropriate stories, or displaying sexual

material. Johnson describes unwanted sexual attention as staring, leering, ogling, or unwanted
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touching by a supervisor or coworker. Sexual coercion includes bribing or pressuring women to

engage in sexual behavior. The data describes, “fewer women in our sample reported sexual

coercion and unwanted sexual attention following the #MeToo movement. In 2016, 25% of

women reported being sexually coerced, and in 2018, that number declined to 16%. Unwanted

sexual attention declined from 66% of women to 25%.” These statistics prove an improvement in

the workplace regarding workplace pressures after the “#The “ MeToo” movement gained

momentum. The study also found, however, “an increase in reports of gender harassment, from

76% of women in 2016 to 92% in 2018”, suggesting that workplaces may see an increase in

hostility toward women due to the movement, otherwise known as the “backlash effect”.

Feelings of self- esteem and self- doubt were also examined, noting that since 2016, an increase

in self-esteem, and a decrease in self-doubt were reported. Women interviewed revealed the

#MeToo movement assisted them in realizing they were not alone in their experiences. The

movement has brought more than awareness to workplaces and, in fact, accentuated the

importance: of preventing sexual assaults: human resource departments offering bystander

intervention training; clear zero-tolerance policies on sexual harassment, and of responding

dutifully to complaints. The work accomplished by human resource departments ensures that

women and men, alike, feel safe to speak up about harassment. Although it took an appalling

case of sexual harassment to gain the following, the #MeToo movement has been proven to

assist in decreasing sexual harassment toward women in the workplace. Progress must continue

in order to resolve all issues present to improve workplace quality for all employees.

Females not only face mistreatment by their male counterparts in the workplace, but also

that of their female co-workers. In her article, “Backlash: Women Bullying Women at Work”,

journalist Mickey Meece discusses the issue of bullying in the workplace specifically that of
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women bullying other women. Events of bullying in the workplace fit a similar description of

those taking place in high school. A survey conducted by the Workplace Bullying Institute has

found that 40% of bullies are women. Men make up the other 60%, but tend to be equal in who

they mistreat regardless of race. Surprisingly, women prefer to target other women and this

targeting occurs 70% of the time. Many women have faced the wrath of bullying by their own

kind. They have quit their jobs and started their own companies. Acts of freezing newcomers out,

pushing, shoving, yelling, sabotage, gossip, and scheming are all examples of mistreatment

women face by other women. To assist in the elimination of bullying, researchers at Wayne State

University created an effective questionnaire that identifies the full range of behaviors defined as

bullying, “most aggressive behavior at work is influenced by a number of factors… This would

include issues related to frustration, personality traits, perceptions of unfair treatment, and an

assortment of stresses and strains associated with today’s leaner and ‘meaner’ work settings.”

Bullying is defined by Meece as verbal or psychological forms of aggression or hostile behavior

that continues over a span of six months or longer. The reasoning behind women choosing

female targets is called into question, and the Bullying Institute explains that women show

aggression when they believe the victim will not respond with aggression. Part of this aggression

involves gender stereotyping, that suggests no matter the position held, women must work twice

as hard as men to achieve the same recognition and proof of ability to lead. Stereotypically,

women are supportive and nurturing. As business leaders, women can sometimes be considered

too soft, but when or if they go against stereotypes, women become viewed as too tough; nothing

is ever just right. Bullying becomes the answer for some women who think by being aggressive,

women feel they will have a better opportunity for promotion. The most effective tactic in

gaining promotion, however, is the ability to be collegial and collaborative, rather than
 Gender Inequalities in the Medical Field 11

competitive. Research has found that women may sabotage and bully other women out of fear

that helping their co-workers will jeopardize their own careers. Bullying their female colleagues

by withholding information like promotional opportunities allows women to feel they can get

ahead. Another stereotype also occurs wherever women make better targets because they are

weaker than men, as “we’re taught or we’re led to believe that we don’t get ahead because of

men. But, we really don’t get ahead because of ourselves. Instead of building each other up and

showcasing each other, we’re constantly tearing each other down.” Instead of working together

to solve issues in the workplace, women are created more for women. Promoting unity rather

than division is the key to overcoming workplace inequality. Females in the workplace already

face mistreatment and inequality often, to then have to endure petty disputes, resembling female

high school behavior demolishes their ability to work as a unit, and create success for all within

the workplace. Females must support each other, rather than cause extra difficulties for other

females

Conclusion

Gender inequality, without a doubt, is present in the medical field, but after thorough

research, medical facilities do not stand alone in producing an impact on this issue. Female

physicians endure a major strain when attempting to balance personal life. While attempting to

stay ahead as mothers, females are set behind and in a way, punished for having a second

occupation, that of caregivers, to come home to. When informing myself on the issues such as

sexual assault and females facing challenges due to their other occupation as a mother, the

ideology of being able to stand up for yourself and ensure change seems like an easy task. I have

realized at the moment when facing the issue face to face, the chances of going into shock are

very high. You can tell yourself you are well educated and prepared to face the dilemma face on
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but when put in the real-life position of needing to take a stand, better preparation is necessary.

Corporations, offices, businesses need to begin to strive to boost the confidence of their

employees and educate each and everyone how to deal with inequality with force. I began this

research investigation curious to discover answers to basic questions such as, if and how

multiculturalism affects inequality; how people currently work to close pay gaps, and where else

does gender inequality exist outside of the job force. While conducting my research topics

addressed within my paper caught my attention. If I had an opportunity to complete this task at

hand I would without a doubt dig deeper expanding on multiculturalism and how people work to

close the pay gaps. While gaining information on my topic of inequality, the article “Backlash:

Women Bullying Women at Work” surprised me the most. Gender inequality before further

investigation was the idea of mistreatment of women-only conducted by men. Female bullying in

the workplace is a constant struggle faced regularly (Meece). The issue of inequality presents

itself in all occupations leaving females struggling to stay ahead. Two times the amount of effort

for the same job is needed to be put forth just to stay ahead (Risse). With a new generation

beginning its service in the workforce, a change must be made to create a healthy workspace for

all people.
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Works Consulted

Ducharme, Jamie. “The Gender Pay Gap for Doctors Is Getting Worse. Here's What Women

Make Compared to Men.” ​Time​, 10 Apr. 2019, time.com/5566602/doctor-pay-gap/.

Jagannathan, Meera. “Female Doctors Are More Likely to Go Part-Time.” ​New York Post,​ 6

Aug. 2019, nypost.com/2019/08/06/female-doctors-are-more-likely-to-go-part-time/.

Brinton, Mary. “Gender Inequality and Women in the Workplace.” ​Harvard Summer School,​

Harvard EDU, 15 Nov. 2018,

www.summer.harvard.edu/inside-summer/gender-inequality-women-workplace​.

Johnson, Stefanie K., et al. “Has Sexual Harassment at Work Decreased Since #MeToo?”

Harvard Business Review,​ 18 July 2019,

hbr.org/2019/07/has-sexual-harassment-at-work-decreased-since-metoo.
 Gender Inequalities in the Medical Field 14

Meece, Mickey. “Backlash: Women Bullying Women at Work.” ​The New York Times,​ 9 May

2009, www.nytimes.com/2009/05/10/business/10women.html.

Risse, Leonora. “Women Have to Work Harder to Be Promoted.” ​CNN​, Cable News Network,

19 Nov. 2018,

www.cnn.com/2018/11/19/health/women-work-harder-gender-pay-gap-intl/index.html​.