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 Researchers analyzed general industry payments, including research
grants, consulting fees, and food and beverage expenses, accrued by
933,295 licensed physicians. Overall, they saw a notable gender
difference in favor of male physicians in relation to engagement
with industry.
“These data are depressingly familiar”, said Ariane Hegewisch,
program director of employment and earnings at the Washington,
D.C.-based Institute for Women’s Policy Research, who was not
involved in the study.
Two-thirds of the doctors in the study were male. Across all
specialties, men received a higher per-physician value of general
payments versus women, with a median difference of $1,470. The
discrepancy in neurosurgery was particularly wide, with the largest
per-physician value of general payments for male neurosurgeons at
$15,821, compared with $3,970 for their female colleagues.
“At first glance, this finding can be interpreted as merely another
example of gender disparities in the workplace, which we have seen
before with gender gaps in physician salaries and research funding,”
said study coauthor Kathryn Tringale of the University of
California, San Diego.
The data could also indicate industry bias resulting in fewer
opportunities for female physicians to engage in profitable
relationships, or gender differences in physician decision-making,
Tringale said.
Female doctors with children may work fewer hours than their male
counterparts, although not every woman physician is a mother, and
not every female doctor who is a mother has reduced her hours, noted
Hegewisch in an email.
“But this is not really a full explanation: why is it that women
take so much more responsibility for their kids and for family care
overall? Discrimination, access to the highest paying opportunities,
and systemic bias in the way funding and patenting systems are set
up are also likely to contribute,” she said.
The study also found that male physicians held 93% of the value
received from ownership interests, including stock options and
partnership shares, and received a higher per-physician value across
most specialties, with the largest difference among radiologists.
However, women physicians in certain fields such as obstetrics,
gynecology, psychiatry and urology, had comparatively higher values
of ownership interest.
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“Perhaps industries purposely target men more than women, presuming
they may have greater influence on market share or sales . . . data
shows that women hold fewer patents than their male counterparts,
which may be explained by fewer initial connections to the
marketplace or exclusion of their name from the patent itself after
idea generation,” Tringale said.
Dr. Jane Orient, executive director of the Association of American
Physicians and Surgeons, suggested what she called another “obvious
explanation.”
Perhaps “women do less of the work that earns the type of payments
being studied,” she said in an email.
The study findings were drawn from the Centers for Medicare &
Medicaid Services National Plan & Provider Enumeration System and
from 2015 Open Payment reports of industry payments to U.S. doctors.
In a subset of 63,466 licensed California practitioners, after
taking years in practice into account, male physicians were still
more likely than female physicians to receive general payments and
hold ownership interests, and the men received more - and
higher-value - general payments, Tringale and her coauthor Dr. Jona
Hattangadi-Gluth wrote in JAMA Internal Medicine.
“We need to further investigate how interactions with industry
influence physician behavior and impact patient care, which we
cannot conclude from these results,” said Tringale.
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