Abstract

This paper primarily focuses on physician income and demonstrates that women initially
concentrated in specialties that have lower pay. The data indicates that as women continued to
concentrate in these particular specialties, the percentage increase in pay was lower than in
specialties with a high concentration of men. Studies conclude that socialization played (and still
plays) a big part in the gender wage gap in that women have been subject to socialization
demanding greater household work and more family friendly jobs. This socialization and
crowding effect are underlying causes of the gender wage gap, but the devaluation of jobs is an
inhibitor to close this gap.

The gender wage gap in the United States has been a highly-debated topic within the
recent history of the country. In summation, the current statement regarding this gap is that
women, on average, make about 76 to 80 percent of what men are making. There is much debate

on the true cause of the gender wage gap, though many economists and sociologists believe that
the issue is multi-faceted. If two people were to agree on the issue that is the gender wage gap,
there could be an additional debate on how to mitigate or completely remove this gap. The
sociological theories and economic data that go into this phenomena is complex, so I will limit
the scope of the gap by only examining the concentration of women in the workforce within the
last half century. Also, I will be examining any kind of correlative effect that the concentration
had on pay during concentration and after it. For the most part, I will be focusing exclusively on
physician income between men and women, as this occupation demonstrates two of the four
reasons for the gender wage gap.
Allison Sahl succinctly explains four reasons for the gender wage gap in her work
Gender Differences in Work-Family Balance, Paid Work, and Unpaid Household Labor:
preference, crowding, power, and socialization. Research from the 1970s
and 1980s suggest that women have personal preferences for jobs that pay less,
however this research was mainly carried out by economists who did not consider
these preferences to be a result of processes such as gender socialization. Other
economists and researchers interested in power differentials between men and
women suggest that men are advantaged by their social superiority (in this
American patriarchal society) and therefore have the ability to earn higher wages
because of these advantages (Kessler-Harris 2007). Sociologists studying the
gender wage gap suggest that because of girls socialization into womens work
they receive secondary status in the labor market (England and Folbre 2005).
Finally, crowding has been used as an explanation for the gender wage gap.
Crowding refers to a larger concentration of women in a smaller number of

occupations which generally have lower pay than jobs with a higher concentration
of men (Bellas and Coventry 2001, Solberg 2005). (Sahl 2015)
My paper will focus almost exclusively on the last explanation that Sahl mentioned, but it is
impossible to do so without at least briefly mentioning the impact of the other three. Sahls
statement on concentration, or crowding, is an interesting one. Again, the concept insinuates
the idea that women join jobs or fields in which the pay is lower. The problem with Sahls
definitions is that she doesnt seem to mention how each one affects the other one. For instance,
we can ask the question: when women concentrate in lower paying jobs, is the percentage
increase in pay over time less than those in occupations still dominantly held by men? This
question blends both the crowding and socialization aspects of the gender wage gap.
Crowding was briefly mentioned in William A. Darity Jr. and Patrick L. Masons article
Evidence on Discrimination in Employment: Codes of Color, Codes of Gender. The authors
mentioned that crowding was heavily apparent in the workforce in 1970 and decreased by
approximately 15 percent in twenty years (Darity Jr. and Mason 1998). However, the authors are
quick to mention that the gap is still quite large and that the differences cannot be explained
well by human capital differences between men and women; women continue to be more
concentrated in lower-paying jobs than men with equivalent levels of education (Darity Jr. and
Mason 1998). We see here that the authors are implying two things: 1) that some have argued
that the reason for this gap is because there is an aggregate difference in human capital between
men and women and 2) this difference in capital is the reason for the gap.
Lets take a look, then, at human capital of men and women in the United States in 1990.
In 1996, the National Center for Education Statistics (NCES) released a report showing certain
discrepancies in education between men and women. The NCES stated that the large gender

differences in earnings persist after taking educational attainment and prose, document, and
quantitative literacy skills into account (NCES 1996). Any attempt to argue that the difference
in pay is due to a difference in education is a futile one. Thus, we must look further for the
difference in the wage gap. Merely saying concentration is not enough; we must look at the
residual effects of initial concentration and the secondary and tertiary sociological effects that
crowding may have had on earnings.
The 1996 NCES report showed a comparison of the percentage distribution in bachelors
degrees between men and women (1972 and 1992). In 1972, women overwhelmingly received
more bachelor degrees in education than men (37 percent to 10 percent). Additionally, women
were far more concentrated in health sciences than men were in 1972 (by 6 to 1). Women also
dominated the modern foreign languages and psychology fields with 4 to 1 and 5 to 5 percent
respectively. While women still had a similar presence in these particular fields 20 years later, its
clear that there was a lack of parity. Let us examine, though, the pay of the education, health
sciences, and psychology fields during the 1970s in respect to the other fields presented in the
study. In 1971-1972, the NCES reports that the average salary of all teachers was $9,705 (about
$49,929 in 2008 dollars) (NCES 2009). In 1991-1992, we can see that the average salary (again,
in 2008 dollars) rose about 4.5 percent within those 20 years (NCES 2009). In 1992, the parity of
men and women in education barely increased, and the rise in earnings was modest. Let us
compare this rise in salary to engineering.
In 1972, the percentage of both women and men in engineering was 0 to 10 percent
respectively. That number didnt change much in 1992 (about 0 to 13 percent). According to the
Bureau of Labor Statistics, in 1971, the average salary for engineers was between $16,000 and
$18,000 (which equals $82,412.63 to $92,714.21 in 2008 dollars respectively), far higher than

the mean salary of educational workers (BLS 1972). This discrepancy indicates that educational
jobs were already valued less than engineering ones in the early 70s. If real wages increase at a
constant rate and if women remain statically concentrated, the gender wage gap shouldnt close
much. According to the American Association of Engineering Societies (AAES), the median
salary for federal government engineers in 1994 was $55,750 ($80,992 in 2008 dollars). The
wages for engineering jobs stayed near constant. In fact, unlike the education wages (which
increased slightly), the engineering wages actually decreased slightly, but the severe gap between
the two occupations are still clear.
The wages increased at a near similar rate, though the difference is enough to close the
gap a little. The place we must then look is the percentage of women in the respective
occupations within that 20 year span. In 1972, men only comprised about 27 percent of the
educational workforce. That number only rose one percent in 20 years. For engineering, virtually
no women were in the workforce in 1972, and while some women were in engineering by 1972,
they comprised about 15 percent of the occupation. If anything, we can see that, as more women
entered the occupation, the pay decreased slightly, but such a claim is inconclusive.
Another particular field that is interesting to examine is health care. According to the
American Academy of Pediatrics, the percentage of women physicians were far lower than men
in 1975 (about 9 percent to 91 percent). In 2011, women comprised of nearly 31 percent of
physicians in the United States (AAP 2011). If we are to speculate any correlations, we can
speculate these two phenomena: 1) because of a higher concentration in women, the overall real
wages of the physician occupation has decreased (at least in specific occupations) and 2) the
gender wage gap should have decreased given that women are increasingly concentrating in
occupations with higher wages. Its certainly possible that both of these phenomena occurred at

the same time. Alicia C. Sasser states that a decrease in occupational segregation in the 1970s
and 1980s was certainly a factor in narrowing the gender wage gap (Sasser 2005); however, there
is still hyper specific occupational segregation present within the United States.
While a women were increasingly becoming physicians, the trend is especially true for
pediatrics. In 1975, women comprised about 23 percent of all pediatricians in the United States
(AAP 2011). That number grew to well over 50 percent by 2011 (AAP 2011). Pediatrics is one
specialty in which there is a higher concentration of women. According to a 2012 report by the
Association of American Medical Colleges (AAMC), only 4 percent of todays orthopedic
surgeons are female (AAMC 2012). As far a general surgery is concerned, women only make up
15 percent (AAMC 2012). Even when we see psychiatry as a whole striving towards parity, the
specialties within the field are still experiencing occupational segregation. Crowding is still in
effect within this field. The BLS reports that pediatricians on average make about $226,000. That
number is nearly double for general surgeons, a specialty in which there are far more men than
women.
As we can see with this one example, women concentrating in the general fields that have
a higher pay isnt quite significant enough to bridge the gender wage gap, though it does help to
narrow it. There are additional specialties that factor into physicians alone. In a 1992 Health
Affairs article titled Trends in Physicians Income, we can see that orthopedic surgery and
cardiovascular surgery are by far the highest paying specialties (Pope and Schneider 1992).
These two specialties are still heavily saturated with male workers with 96 percent and 89.2
percent respectively (AAMC 2012). The lowest paying specialties include general/family
practice, internal medicine, and pediatrics (Pope and Schneider 1992). These three specialties
have had a greater percentage of women--the first two having percentages in the 30s and

pediatrics, again, above 50 (AAMC 2012). From the data that we can see, women are
concentrating in specialties that pay less, but the interesting thing to note is the percentage of
wage increase over time.
We can examine the specialties within psychiatrics and see which particular specialties
have experienced a generally greater increase in pay. The results are fairly similar to the
differences in average earnings. Cardiology and orthopedic surgery received the greatest increase
in pay from the years 1983-1988 with 52.5 percent and 63 percent respectively (Pope and
Schneider 1992). The next highest specialty is Ophthalmology with 43.2 percent, and the AAMC
data shows that there is still a high concentration of males in such a specialty. The percentage
increase in lower paying specialties mirrors their average earnings. General/ family practice and
internal medicine saw the smallest increase in pay, and pediatrics wasnt much better (Pope and
Schneider). Two possible scenarios are at play here: either the skills required for the top paying
specialties increased significantly or specialties that saw an increasing percentage of women
were being devalued. Sahls idea of socialization would say that the latter is most likely the case.
At least for the sake of physicians, in order to see how all of this blends together in the
gender wage gap, we must finally examine the pay that women physicians receive an average
compared to men. In a study published by The New England Journal of Medicine titled
Differences in Earnings Between Male and Female Physicians, Laurence C. Baker compares
the pay of women physicians to the pay of men physicians by specialty. In every single specialty,
women are, on average, paid less than men (Baker 1996). This trend having been said, baker
draws some interesting conclusions:
In 1990, young male physicians earned 41 percent more per year than
young female physicians (male:female earnings ratio, 1.41; 95 percent confidence

interval, 1.34 to 1.49). Per hour, young men earned 14 percent more than young
women (ratio, 1.14; 95 percent confidence interval, 1.09 to 1.20). However, after
adjustment for differences in specialty, practice setting, and other characteristics,
no earnings difference was evident. (Baker 1996)
Baker accounts for these other characteristics in order to demonstrate parity in earnings. The
question we must ask is, should these certain characteristics be accounted for? One of the
greatest factors involving pay has to do with marriage and children. Women who are not married
and without children had pay practically equal to men (Baker 1996). Women who are married
start to see a difference in pay from men, and women who are married with children see a cut in
pay with a tremendous gap in earnings from men.
Lack of paid maternal leave is applicable here, but even if we do account for these
variables, to say that earnings are equal, while true, is misleading in terms of the bigger picture.
As stated before, the specialties that received the greatest increase in pay are specialties with the
greatest percentage of men. Those that received the lowest increase in pay are specialties with
higher concentrations of women. What this correlation indicates is that this phenomena is not a
factor contributing to the gender wage gap; rather, it is an inhibitor in womens ability to close
the gap.
Alicia C. Sasser presents to us a contextualization regarding the marriage/ family statistic
that Baker presented. In her article titled Gender Differences in Physician Pay: Tradeoffs
Between Career and Family, Sasser argues that women suffer from pay cuts in family life while
men do not. Sasser lists four reasons as to why family responsibilities might have negative
effects on womens pay: first, if women are bearing the majority of household responsibilities,
they are reducing the amount of time acquiring capital from their respective specialties; second,

some argue that women with children have lower productivity or commitment to the labor
market; third, greater household working conditions may have an effect on womens demand
for more family-friendly jobs; fourth, the earnings are a result of pure employer discrimination
(Sasser 2005).
All of these factors (within physicians) seem to point to us a chain that encompasses
Sahls reasons for the gender wage gap. There is a four part speculation here. First, women are
socialized to take on more household work. When women started to enter into the workforce
(even in high skill jobs), women concentrated in specialties that were more family friendly
because of this socialization. Women who are married and with children are penalized due to
lack of maternity leave. When women continued to concentrate in these jobs and other
specialties, the pay increase in these highly crowded jobs were less than those with a fewer
amount of women. The first three parts of the test all serve as reasons for the cause of the gender
wage gap. The last part serves as a barrier for women to close this gap unless women choose to
concentrate in specialties with a higher concentration of men.
Sasser concludes that the lower earnings of married women and women with children
within medicine primarily reflect a reduction in hours worked and are not driven by negative
selection into marriage and motherhood (Sasser 2005). Without maternity leave, this conclusion
implies that socialization is the primary cause for the gender wage gap in physician income.
Because women are still found to take on the housework role, the lower pay is likely not a result
of pure discrimination in the workforce, but rather a discriminatory cultural paradigm. Sasser
later writes that, in many ways, the results presented in this paper have positive implications for
women in medicine that may also apply to other professions such as law or business (Sasser
2005). Looking at the medical field alone, Sahls definition of socialization is the primary cause

of the gap in pay between men and women. However, there is a noticeable correlation that, as
women concentrate in certain specialties, the increase in pay is less significant than in specialties
with fewer number of women. To conclude, as long as socialization is present, and as long as this
pay-increase inhibitor dependent on crowding is present, the pay gap between men and women
will continue to persist in the United States.

References
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