Dataset Information

Physician Work Hours and the Gender Pay Gap - Evidence from Primary Care.

ABSTRACT:

Background

The gender gap in physician pay is often attributed in part to women working fewer hours than men, but evidence to date is limited by self-report and a lack of detail regarding clinical revenue and gender differences in practice style.

Methods

Using national all-payer claims and data from electronic health records, we conducted a cross-sectional analysis of 24.4 million primary care office visits in 2017 and performed comparisons between female and male physicians in the same practices. Our primary independent variable was physician gender; outcomes included visit revenue, visit counts, days worked, and observed visit time (interval between the initiation and the termination of a visit). We created multivariable regression models at the year, day, and visit level after adjustment for characteristics of the primary care physicians (PCPs), patients, and types of visit and for practice fixed effects.

Results

In 2017, female PCPs generated 10.9% less revenue from office visits than their male counterparts (-$39,143.2; 95% confidence interval [CI], -53,523.0 to -24,763.4) and conducted 10.8% fewer visits (-330.5 visits; 95% CI, -406.6 to -254.3) over 2.6% fewer clinical days (-5.3 days; 95% CI, -7.7 to -3.0), after adjustment for age, academic degree, specialty, and number of sessions worked per week, yet spent 2.6% more observed time in visits that year than their male counterparts (1201.3 minutes; 95% CI, 184.7 to 2218.0). Per visit, after adjustment for PCP, patient, and visit characteristics, female PCPs generated equal revenue but spent 15.7% more time with a patient (2.4 minutes; 95% CI, 2.1 to 2.6). These results were consistent in subgroup analyses according to the gender and health status of the patients and the type and complexity of the visits.

Conclusions

Female PCPs generated less visit revenue than male colleagues in the same practices owing to a lower volume of visits, yet spent more time in direct patient care per visit, per day, and per year. (Funded in part by the Robert Wood Johnson Foundation.).

SUBMITTER: Ganguli I

PROVIDER: S-EPMC10854207 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Publications

Physician Work Hours and the Gender Pay Gap - Evidence from Primary Care.

Ganguli Ishani I Sheridan Bethany B Gray Joshua J Chernew Michael M Rosenthal Meredith B MB Neprash Hannah H

The New England journal of medicine 20201001 14

<h4>Background</h4>The gender gap in physician pay is often attributed in part to women working fewer hours than men, but evidence to date is limited by self-report and a lack of detail regarding clinical revenue and gender differences in practice style.<h4>Methods</h4>Using national all-payer claims and data from electronic health records, we conducted a cross-sectional analysis of 24.4 million primary care office visits in 2017 and performed comparisons between female and male physicians in th ...[more]

PMID: 32997909

Similar Datasets

Project description:ImportanceThe share of the population covered by accountable care organizations (ACOs) is growing, but the association between this increase and physician employment is unknown.ObjectiveTo investigate the association between the growth of ACOs and changes in physician work hours, probability of being self-employed, and probability of working in a hospital.Design, setting, and participantsA fixed-effects design was used in this cross-sectional study to compare changes in physician employment in hospital referral regions with high vs low ACO growth. A nationally representative 1% sample of all working US physicians obtained annually from 2011 through 2015 from the American Community Survey (N = 49 582) was included. Data analysis was conducted from March 28, 2017, to April 10, 2018.Main outcomes and measuresPhysician hours worked per week, probability of being self-employed, and probability of working in a hospital.ResultsOf the 49 582 physicians included in the study, 63.5% were men; the mean (SD) age of sampled physicians was 46.01 (11.59) years. In 2011, sampled physicians worked a mean (SD) of 52.2 (16.1) hours per week, 24.43% were self-employed, and 42.03% worked in a hospital. A 10-percentage point increase in ACO enrollment in a hospital referral region was associated with a statistically significant reduction of 0.82 (95% CI, -1.52 to -0.13; P = .02) work hours in men and a decrease of 2% (95% CI, -3.8% to -0.1%; P = .04) in the probability of all physicians being self-employed. The association with self-employment was strongest (-5.0%; 95% CI, -8.7% to -1.4%; P = .006) in physicians aged 50 to 69 years, who were also more likely (4.0%; 95% CI, 1.0% to 6.9%; P = .009) to work in a hospital.Conclusions and relevanceThe growth of ACOs within hospital referral regions appears to be associated with a reduction in hours of work and self-employment among physicians. These results suggest that ACOs may affect physician employment patterns.

Dataset Information

Physician Work Hours and the Gender Pay Gap - Evidence from Primary Care.

Background

Methods

Results

Conclusions

Publications

Physician Work Hours and the Gender Pay Gap - Evidence from Primary Care.

Similar Datasets

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