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Equal work for unequal pay: the gender reimbursement gap for healthcare providers in the United States
  1. Tejas Desai1,2,
  2. Sadeem Ali3,
  3. Xiangming Fang4,
  4. Wanda Thompson5,
  5. Pankaj Jawa3,
  6. Tushar Vachharajani1
  1. 1Division of Nephrology, WG (Bill) Hefner VA Medical Center, Salisbury, North Carolina, USA
  2. 2NOD Analytics, Charlotte, North Carolina, USA
  3. 3Division of Nephrology, East Carolina University—Brody School of Medicine, Greenville, North Carolina, USA
  4. 4Department of Biostatistics, East Carolina University—Brody School of Medicine, Greenville, North Carolina, USA
  5. 5Office of the Chief of Staff, WG (Bill) Hefner VA Medical Center, Salisbury, North Carolina, USA
  1. Correspondence to Dr Tejas Desai, Division of Nephrology, Department of Medicine, 1601 Brenner Avenue, Building 21, Salisbury, NC 28144, USA; Tejas.p.desai{at}


Introduction Gender disparities in income continue to exist, and many studies have quantified the gap between male and female workers. These studies paint an incomplete picture of gender income disparity because of their reliance on notoriously inaccurate or incomplete surveys. We quantified gender reimbursement disparity between female and male healthcare providers using objective, non-self-reported data and attempted to adjust the disparity against commonly held beliefs as to why it exists.

Methods We analysed over three million publicly available Medicare reimbursement claims for calendar year 2012 and compared the reimbursements received by male and female healthcare providers in 13 medical specialties. We adjusted these reimbursement totals against how hard providers worked, how productive each provider was, and their level of experience. We calculated a reimbursement differential between male and female providers by primary medical specialty.

Results The overall adjusted reimbursement differential against female providers was −US$18 677.23 (95% CI −US$19 301.94 to −US$18 052.53). All 13 specialties displayed a negative reimbursement differential against female providers. Only two specialties had reimbursement differentials that were not statistically significant.

Conclusions After adjustment for how hard a physician works, his/her years of experience and his/her productivity, female healthcare providers are still reimbursed less than male providers. Using objective, non-survey data will provide a more accurate understanding of this reimbursement inequity and perhaps lead the medical profession (as a whole) towards a solution that can reverse this decades-old injustice.

  • reimbursement
  • gender
  • disparity
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