Male-specific procedures pay doctors 44% more—the insidious, fascinating, utterly infuriating reason women get worse health care
A longstanding pay disparity
In 2021, gynecologic surgeon Dr. Louise King and bioethics professor Katie L. Watson discussed the persistent pay gap affecting female surgeons. Watson described the overlapping disadvantage facing gynecologic surgeons as “double discrimination.”
A 1997 study by Dr. Barbara A. Goff and colleagues found that doctors received about 44 percent more for male-specific procedures than for analogous female-specific ones. The disparity remains, with gynecologic procedures often reimbursed at lower rates despite requiring similar time and skill.
How procedure values are set
A committee of doctors largely determines the value assigned to each procedure. Its decisions rely on surveys in which doctors report how much skill and time their own procedures require.
Those reports are self-reported and can be inaccurate. The resulting payment codes have helped embed lower reimbursement for many female-specific procedures in the system used to bill for surgery.
Effects on care and training
Lower payments can make hospitals less inclined to provide gynecological services because those procedures bring in less revenue. That can reduce resources for women’s health care and contribute to worse outcomes.
Fewer services can also mean fewer training opportunities for surgeons in the field. Experts say the gap could be addressed by rethinking how gynecologic surgeries are valued and removing sex-specific billing codes.
Key points
- A 1997 study found doctors were paid about 44 percent more for male-specific procedures than analogous female-specific ones.
- Gynecologic procedures can receive lower payments despite requiring similar time and skill.
- Lower reimbursement can discourage hospitals from offering women’s health services.
- Experts point to revised procedure valuations and removing sex-specific billing codes as possible remedies.