Structural Factors, Power, and the Physician Sex Pay Gap

To the Editor I read with interest the study by Bravender et al¹ demonstrating that the increasing number of women in a specialty is associated with lower salaries for both women and men. The authors conclude that “larger systemic issues”¹ must be addressed to narrow the physician sex pay gap, yet their discussion avoids articulating these issues. While I agree that the pay disparity between procedural and cognitive specialties likely accounts for their findings, their suggestion for why women choose cognitive specialties elides the structural factors that influence such choices.