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.
Highlights
In many OECD countries, the gender differences in physicians’ pay favour male doctors
We found that general practitioners (GPs) practicing in rural regions have a greater income than those practicing in urban areas (p < 0.01) [23], which could be explained by different patients profiles and/or by the type of services provided
We study the gender differences in returns of the different explanatory variables on gross income (GI): the first term reflects the nature of the returns for men relative to the GP population and corresponds to an advantage for male when the term is positive (Appendix A); the second term reflects the nature of returns for women that corresponds to an disadvantage if the term is positive
Summary
In many OECD countries, the gender differences in physicians’ pay favour male doctors. The objective of this study is to measure and analyse the 2008 income gap between males and females general practitioners (GPs). In France, as in many OECD countries, there has been a recent and strong feminisation of medicine, for general practitioners (GPs) [1,2]. In the context of health, the first studies that analysed the income gap between male and female physicians were conducted in the United States during the 1970s [12,13]. Using the same physician dataset, Bashaw and Heywood (2001) explained these results by the differences in working time productivities: women typically worked fewer hours than men, and because of the “law” of diminishing marginal productivity, women had higher hourly earnings than men. The decrease in working time productivity of physicians is according to the authors in favour of women because they worked fewer hours [15]
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