Race and Gender Differences in General Internists' Annual Incomes

BACKGROUND: Specialty, work effort, and female gender have been shown to be associated with physicians' annual incomes; however, racial differences in physician incomes have not been examined. OBJECTIVE: To determine the influence of race and gender on General Internists' annual incomes after controlling for work effort, provider characteristics, and practice characteristics. DESIGN: Retrospective survey-weighted analysis of survey data. PARTICIPANTS: One thousand seven hundred and forty-eight actively practicing General Internists who responded to the American Medical Association's annual survey of physicians between 1992 and 2001. MEASUREMENTS: Work effort, provider and practice characteristics, and adjusted annual incomes for white male, black male, white female, and black female General Internists. RESULTS: Compared with white males, white females completed 22% fewer patient visits and worked 12.5% fewer hours, while black males and females reported completing 17% and 2.8% more visits and worked 15% and 5.5% more annual hours, respectively. After adjustment for work effort, provider characteristics, and practice characteristics, black males' mean annual income was $188,831 or$7,193 (4%) lower than that for white males (95% CI: −$31,054,$16,669; P =.6); white females' was $159,415 or$36,609 (19%) lower (95% CI: −$25,585, −$47,633; P <.001); and black females' was $139,572 or$56,452 (29%) lower (95% CI: −$93,383, −$19,520; P =.003). CONCLUSIONS: During the 1990s, both black race and female gender were associated with lower annual incomes among General Internists. Differences for females were substantial. These findings warrant further exploration