The Link Between Workplace Diversity and the Gender Pay Gap

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In nearly every pro­fes­sion, women are paid less than men. In med­i­cine, where detailed data on doc­tors’ pro­duc­tiv­i­ty, hours worked, edu­ca­tion, and expe­ri­ence are avail­able and gender dif­fer­ences in these have been account­ed for, numer­ous studies still show that a gender gap exists. To put it simply, women earn less than men for the same work.

Many fac­tors explain the gender earn­ings gap, includ­ing implic­it and explic­it biases (PDF) in the work­place, gender dif­fer­ences in how credit is attributed (PDF), and dif­fer­ences in how men and women negotiate.

But we’ve iden­ti­fied anoth­er factor that could influ­ence the pay women receive: the number of men in their work­place.

In a study (PDF) pub­lished in the British Medical Journal, we com­bined salary data for 18,802 doc­tors with infor­ma­tion on the number of male and female doc­tors in each work­place. We sus­pect­ed that female doc­tors might get paid less in prac­tices over­whelm­ing­ly made up of male doc­tors, per­haps because they could find it harder to nego­ti­ate for higher pay with a group of doctor col­leagues that is mostly men.

Indeed, they do get paid less.

Gender Diversity Could Shrink Pay Gap

Among spe­cial­ist doc­tors, women who worked in prac­tices with an equal number of male and female doc­tors had a rel­a­tive­ly small dif­fer­ence in pay (women were still paid less, how­ev­er). But in prac­tices pri­mar­i­ly made up of male doc­tors, female doc­tors’ salaries were sub­stan­tial­ly lower. This was true even after account­ing for dif­fer­ences between men and women in spe­cial­ty, prac­tice type and geog­ra­phy, years of expe­ri­ence and clin­i­cal rev­enue.

In prac­tices pri­mar­i­ly made up of male doc­tors, female doc­tors’ salaries were sub­stan­tial­ly lower.

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A good exam­ple is sur­geons, where women work­ing in prac­tices with an equal number of male and female doc­tors earned about $46,500 less a year than their male coun­ter­parts — a large dollar amount but about 10% less than male sur­geons. As the pro­por­tion of male sur­geons in the prac­tice increased, so did the gender pay gap, peak­ing at a $149,460 dif­fer­ence for female sur­geons who worked in prac­tices where 90% or more sur­geons were men.

We found sim­i­lar pat­terns for non­sur­gi­cal spe­cial­ists like car­di­ol­o­gists, der­ma­tol­o­gists, and gas­troen­terol­o­gists. For pri­ma­ry care doc­tors, how­ev­er, the gender pay gap was no greater in prac­tices that were over­whelm­ing­ly male. This could be due to the much larger pro­por­tion of pri­ma­ry care doc­tors who are women. In our data, only about 5% of pri­ma­ry care doc­tors worked in prac­tices that had 90% or more male doc­tors, where­as 44% of sur­geons worked in prac­tices that had 90% or more male sur­geons.

There are many rea­sons to care about gender diver­si­ty in the work­place. But the pos­si­bil­i­ty that increas­ing the number of women in work­places could reduce the gender wage gap hasn’t received much empir­i­cal atten­tion, in part because the detailed data required to study this issue is dif­fi­cult to obtain in most indus­tries.

22% of the over­all gender pay gap among sur­geons could be explained by the large salary dif­fer­ences present between men and women in dis­pro­por­tion­ate­ly male prac­tices.

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Although our study was spe­cif­ic to med­i­cine, it relied on the fact that unique data on doc­tors’ demo­graph­ics, expe­ri­ence, train­ing, and pro­duc­tiv­i­ty could be com­bined with infor­ma­tion on the gender com­po­si­tion of their work­places (their prac­tices) to study the link between work­place diver­si­ty and the gender pay gap.

The gender pay gap we observed in pre­dom­i­nant­ly male prac­tices was large: 22% of the over­all gender pay gap among sur­geons could be explained by the large salary dif­fer­ences present between men and women in dis­pro­por­tion­ate­ly male prac­tices. Put dif­fer­ent­ly, if the gender pay gap we observed in prac­tices with fewer than 50% male sur­geons were applied to all surgery prac­tices, the over­all gender pay gap in surgery would fall by nearly a quar­ter.

Systemic Bias Against Women

Our study could­n’t iden­ti­fy why female doc­tors were paid sub­stan­tial­ly less in prac­tices made up of mostly male doc­tors. It could be that in “male dom­i­nat­ed” prac­tices, women might not have the same pro­mo­tion or work oppor­tu­ni­ties as women who work in more diverse prac­tices. The rea­sons for this might range from out­right dis­crim­i­na­tion to more subtle forms of dis­crim­i­na­tion, such as lack of suf­fi­cient mater­ni­ty leave. Here, qual­i­ta­tive stud­ies could be reveal­ing.

But stud­ies within health care sup­port our hypoth­e­sis that sys­tem­at­ic dif­fer­ences in how female doc­tors are treat­ed might explain why they are paid sub­stan­tial­ly less in prac­tices pre­dom­i­nant­ly male. Female doc­tors in pre­dom­i­nant­ly male prac­tices receive fewer patient referrals (PDF), or refer­rals for less prof­itable patients. Female doc­tors are also less likely to be referred to as a “doctor” than their male col­leagues, and more than 30% of female doc­tors also report having expe­ri­enced sexual harassment or sex dis­crim­i­na­tion. Among aca­d­e­m­ic doc­tors, women have lower mentor involvement and lead­er­ship oppor­tu­ni­ties.

Our research sug­gests that wom­en’s col­leagues might have a mean­ing­ful impact on their pay. And while our study was focused on doc­tors, it’s likely that these same dynam­ics exist for other pro­fes­sions as well. Increased atten­tion to work­place diver­si­ty isn’t just an impor­tant goal in and of itself, but it could also help close the gender pay gap.


Christopher Whaley is an econ­o­mist and policy researcher at the RAND Corporation. Dr. Anupam B. Jena is an econ­o­mist, a physi­cian and the Ruth L. Newhouse Associate Professor at Harvard Medical School.

This com­men­tary orig­i­nal­ly appeared on USA Today on August 14, 2020. Commentary gives RAND researchers a plat­form to convey insights based on their pro­fes­sion­al exper­tise and often on their peer-reviewed research and analy­sis.

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