To the Editor In response to the Research Letter titled “Trends in Earnings of Male and Female Health Care Professionals in the United States, 1987-2010” and the accompanying Invited Commentary, the decision by Seabury et al1 and Cooke2 to control for variables such as demographic characteristics, state, work hours, and tenure is well-constructed and laudable. However, their conclusion that gender inequities in compensation are “persistent” is premature. Neither Seabury et al1 nor Cooke2 present data on clinical collections, relative value units, or benefit packages, all of which can be critical elements of total compensation. Years of experience and practice location type (private practice, satellite clinic vs hospital based, multiphysician office vs solo) are completely ignored, when such factors contribute materially in terms of productivity, entrepreneurship, and risk. Extramural research funding and philanthropic or investment fundraising are also neglected. A recent study commissioned by the US Department of Labor states “Research indicates that women may value non-wage benefits more than men do, and as a result prefer to take a greater portion of their compensation in the form of health insurance and other fringe benefits.”3(p2) In summary, this letter and commentary do not control for many relevant, nondiscriminatory, and potentially explanatory variables in physician compensation.
Ambati B. Gender Income Disparities Can Be Explained by Alternative Factors. JAMA Intern Med. 2014;174(5):822-823. doi:10.1001/jamainternmed.2014.48