Exploration of Leisure Time Valuation to Explain Sex-Based Wage Gaps among Salaried Primary Care Physicians in the US
DOI:
https://doi.org/10.6000/1929-7092.2017.06.41Keywords:
Sex-based wage gaps, primary care physicians, workforce, gender, physician incomeAbstract
In the US, female physicians have lower hourly incomes than their male counterparts, across specialties and after adjusting for physician and practice characteristics; however, female physicians work fewer hours than their male counterparts. We wanted to determine whether a simple method of valuing leisure time - overtime pay - might help explain sex-based wage gaps among US primary care physicians. Therefore, we used Community Tracking Study Physician Survey data from 1996-2005 to model the impact of overtime pay on sex-based wage gaps. As overtime premiums increased in our models, sex-based wage disparities decreased: they become statistically insignificant when overtime wages reached 0%, 32%, and 61% premiums using the ordinary least squared model and with 0%, 62%, and 55% premiums using the propensity score weighted model, for internal medicine, family practice, and pediatric physicians, respectively. We conclude that modest overtime premiums reduced sex-based hourly wage gaps for the salaried primary care physicians we examined. Future analyses of sex-based wage gaps should account for leisure time and its trade for work hours when it becomes scarce.
References
Armstrong, K. (2012). Methods in comparative effectiveness research. J Clin Oncol, 30, 4208-4214.
https://doi.org/10.1200/JCO.2012.42.2659
Austin, P.C. (2011). An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies. Multivariate Behav Res, 46, 399-424.
https://doi.org/10.1080/00273171.2011.568786
Austin, P.C., Grootendorst, P., & Anderson, G.M. (2007). A comparison of the ability of different propensity score models to balance measured variables between treated and untreated subjects: a Monte Carlo study. Stat Med, 26, 734-753.
https://doi.org/10.1002/sim.2580
Baker, L.C. (1996). Differences in earnings between male and female physicians. NEJM, 334, 960-964.
https://doi.org/10.1056/NEJM199604113341506
Bourguignon, F., & Chiappori, P.A. (1992). Collective models of household behavior: an introduction. European Economic Review, 36, 355-364.
https://doi.org/10.1016/0014-2921(92)90091-A
Chavey, W.E., Medvedev, S., Hohmann, S., & Ewigman, B. (2014). The status of adult inpatient care by family physicians at US academic medical centers and affiliated teaching hospitals 2003 to 2012: the impact of the hospitalist movement. Family Medicine, 46, 94-99.
Dumontet, M., Le Valliant, M., & Franc, C. (2012). What determines the income gap between French male and female GPs - the role of medical practices. BMC Family Practice, 13, 94.
https://doi.org/10.1186/1471-2296-13-94
Floyd, P. (2014). Roadmap for physician compensation in a value-based world. Physician Leadership Journal, 1, 14-21.
Glass, K.P., Pieper, L.E., & Berlin, M.F. (1999). Incentive-based physician compensation models. Journal of Ambulatory Care Management, 22, 36-46.
https://doi.org/10.1097/00004479-199907000-00008
Gravelle, H., Hole, A.R., & Santos, R. (2011). Measuring and testing for gender discrimination in physician pay: English family doctors. Journal of Health Economics, 30, 660-674.
https://doi.org/10.1016/j.jhealeco.2011.05.005
Hanoch, G. (1965). The 'backward-bending' supply of labor. Journal of Political Economy, 73, 636-642.
https://doi.org/10.1086/259089
Kehrer, B.H. (1976). Factors affecting the incomes of men and women physicians: an exploratory analysis. Journal of Human Resources, 11, 526-545.
https://doi.org/10.2307/145430
Kocher, R., & Sahni, N.R. (2011). Hospitals' race to employ physicians - the logic behind a money-losing proposition. NEJM, 364, 1790-1793.
https://doi.org/10.1056/NEJMp1101959
Leigh, J.P., Tancredit, D., Jerant, A., & Kravitz, R.L. (2010). Physician wages across specialties: informing the physician reimbursement debate. Archives of Internal Medicine, 170, 1728-1734.
https://doi.org/10.1001/archinternmed.2010.350
Lo Sasso, A.T., Richards, M.R., Chou, C., & Gerber, S.E. (2010). The $16,819 pay gap for newly trained physicians: the unexplained trend of men earning more than women. Health Affairs, 30, 193-201.
https://doi.org/10.1377/hlthaff.2010.0597
MGMA (2011). Medical Directorship and On-Call Compensation Survey: 2010 Report Based on 2009 Data. Englewood, CO: Medical Group Management Association.
Mitchell, J.B. (1984). Why do women physicians work fewer hours than men physicians? Inquiry, 21, 361-368.
O'Malley, A.S., Bond, A.M., & Berenson, R.A. (2011). Rising hospital employment of physicians: better quality, higher costs? Center for Health System Change Issue Brief, 136, 1-4.
Oaxaca, R.L. (1973). Male-female wage differentials in urban labor markets. International Economic Review, 14, 693-709.
https://doi.org/10.2307/2525981
Oaxaca, R.L., & Ransom, M.R. (1999). Note: Identification in detailed wage decompostions. The Review of Economics and Statistics, 81, 154-157.
https://doi.org/10.1162/003465399767923908
Ohsfeldt, R.L., & Culler, S.D. (1986). Differences in income between male and female physicians. Journal of Health Economics, 5, 335-346.
https://doi.org/10.1016/0167-6296(86)90008-1
Rizzo, J.A., & Blumenthal, D. (1996). Is the target income hypothesis an economic heresy? Medical Care Research and Review, 53, 243-265.
https://doi.org/10.1177/107755879605300301
Scheiber, N. Obama sets rule change to expand overtime (page B1). The New York Times. New York, New York.
Staiger, D.O., Auerbach, D.I., & Buerhaus, P.I. (2010). Trends in the work hours of physicians in the United States. JAMA, 303, 747-753.
https://doi.org/10.1001/jama.2010.168
US Department of Labor. Wage and Hour Division, United States Department of Labor: Overtime Pay. Washington, DC.
Weeks, W.B., Paraponaris, A., & Ventelou, B. (2013). Sex-based differences in income and response to proposed financial incentives among general practitioners in France. Health Policy, 113, 199-205.
https://doi.org/10.1016/j.healthpol.2013.09.016
Weeks, W.B., Wallace, T.A., & Wallace, A.E. (2009). How do race and sex affect the earnings of primary care physicians? Health Affairs, 28, 557-566.
https://doi.org/10.1377/hlthaff.28.2.557
https://doi.org/10.1200/JCO.2012.42.2659
Austin, P.C. (2011). An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies. Multivariate Behav Res, 46, 399-424.
https://doi.org/10.1080/00273171.2011.568786
Austin, P.C., Grootendorst, P., & Anderson, G.M. (2007). A comparison of the ability of different propensity score models to balance measured variables between treated and untreated subjects: a Monte Carlo study. Stat Med, 26, 734-753.
https://doi.org/10.1002/sim.2580
Baker, L.C. (1996). Differences in earnings between male and female physicians. NEJM, 334, 960-964.
https://doi.org/10.1056/NEJM199604113341506
Bourguignon, F., & Chiappori, P.A. (1992). Collective models of household behavior: an introduction. European Economic Review, 36, 355-364.
https://doi.org/10.1016/0014-2921(92)90091-A
Chavey, W.E., Medvedev, S., Hohmann, S., & Ewigman, B. (2014). The status of adult inpatient care by family physicians at US academic medical centers and affiliated teaching hospitals 2003 to 2012: the impact of the hospitalist movement. Family Medicine, 46, 94-99.
Dumontet, M., Le Valliant, M., & Franc, C. (2012). What determines the income gap between French male and female GPs - the role of medical practices. BMC Family Practice, 13, 94.
https://doi.org/10.1186/1471-2296-13-94
Floyd, P. (2014). Roadmap for physician compensation in a value-based world. Physician Leadership Journal, 1, 14-21.
Glass, K.P., Pieper, L.E., & Berlin, M.F. (1999). Incentive-based physician compensation models. Journal of Ambulatory Care Management, 22, 36-46.
https://doi.org/10.1097/00004479-199907000-00008
Gravelle, H., Hole, A.R., & Santos, R. (2011). Measuring and testing for gender discrimination in physician pay: English family doctors. Journal of Health Economics, 30, 660-674.
https://doi.org/10.1016/j.jhealeco.2011.05.005
Hanoch, G. (1965). The 'backward-bending' supply of labor. Journal of Political Economy, 73, 636-642.
https://doi.org/10.1086/259089
Kehrer, B.H. (1976). Factors affecting the incomes of men and women physicians: an exploratory analysis. Journal of Human Resources, 11, 526-545.
https://doi.org/10.2307/145430
Kocher, R., & Sahni, N.R. (2011). Hospitals' race to employ physicians - the logic behind a money-losing proposition. NEJM, 364, 1790-1793.
https://doi.org/10.1056/NEJMp1101959
Leigh, J.P., Tancredit, D., Jerant, A., & Kravitz, R.L. (2010). Physician wages across specialties: informing the physician reimbursement debate. Archives of Internal Medicine, 170, 1728-1734.
https://doi.org/10.1001/archinternmed.2010.350
Lo Sasso, A.T., Richards, M.R., Chou, C., & Gerber, S.E. (2010). The $16,819 pay gap for newly trained physicians: the unexplained trend of men earning more than women. Health Affairs, 30, 193-201.
https://doi.org/10.1377/hlthaff.2010.0597
MGMA (2011). Medical Directorship and On-Call Compensation Survey: 2010 Report Based on 2009 Data. Englewood, CO: Medical Group Management Association.
Mitchell, J.B. (1984). Why do women physicians work fewer hours than men physicians? Inquiry, 21, 361-368.
O'Malley, A.S., Bond, A.M., & Berenson, R.A. (2011). Rising hospital employment of physicians: better quality, higher costs? Center for Health System Change Issue Brief, 136, 1-4.
Oaxaca, R.L. (1973). Male-female wage differentials in urban labor markets. International Economic Review, 14, 693-709.
https://doi.org/10.2307/2525981
Oaxaca, R.L., & Ransom, M.R. (1999). Note: Identification in detailed wage decompostions. The Review of Economics and Statistics, 81, 154-157.
https://doi.org/10.1162/003465399767923908
Ohsfeldt, R.L., & Culler, S.D. (1986). Differences in income between male and female physicians. Journal of Health Economics, 5, 335-346.
https://doi.org/10.1016/0167-6296(86)90008-1
Rizzo, J.A., & Blumenthal, D. (1996). Is the target income hypothesis an economic heresy? Medical Care Research and Review, 53, 243-265.
https://doi.org/10.1177/107755879605300301
Scheiber, N. Obama sets rule change to expand overtime (page B1). The New York Times. New York, New York.
Staiger, D.O., Auerbach, D.I., & Buerhaus, P.I. (2010). Trends in the work hours of physicians in the United States. JAMA, 303, 747-753.
https://doi.org/10.1001/jama.2010.168
US Department of Labor. Wage and Hour Division, United States Department of Labor: Overtime Pay. Washington, DC.
Weeks, W.B., Paraponaris, A., & Ventelou, B. (2013). Sex-based differences in income and response to proposed financial incentives among general practitioners in France. Health Policy, 113, 199-205.
https://doi.org/10.1016/j.healthpol.2013.09.016
Weeks, W.B., Wallace, T.A., & Wallace, A.E. (2009). How do race and sex affect the earnings of primary care physicians? Health Affairs, 28, 557-566.
https://doi.org/10.1377/hlthaff.28.2.557
Downloads
Published
2017-06-09
How to Cite
Weeks, W. B., & Ventelou, B. (2017). Exploration of Leisure Time Valuation to Explain Sex-Based Wage Gaps among Salaried Primary Care Physicians in the US. Journal of Reviews on Global Economics, 6, 395–403. https://doi.org/10.6000/1929-7092.2017.06.41
Issue
Section
Articles
License
Policy for Journals/Articles with Open Access
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work
Policy for Journals / Manuscript with Paid Access
Authors who publish with this journal agree to the following terms:
- Publisher retain copyright .
- Authors are permitted and encouraged to post links to their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work .
