Exploration of Leisure Time Valuation to Explain Sex-Based Wage Gaps among Salaried Primary Care Physicians in the US


  • William B. Weeks The Dartmouth Institute for Health Policy and Clinical Practice, Williamson Translational Building, DHMC, NH, 03766, Lebanon
  • Bruno Ventelou Aix-Marseille University, (Aix-Marseille School of Economics), CNRS & EHESS, 2 Place Leverrier, Marseille, 13004, France




Sex-based wage gaps, primary care physicians, workforce, gender, physician income


In the US, female physicians have lower hourly incomes than their male counterparts, across specialties and after adjusting for physician and practice characteristics; however, female physicians work fewer hours than their male counterparts. We wanted to determine whether a simple method of valuing leisure time - overtime pay - might help explain sex-based wage gaps among US primary care physicians. Therefore, we used Community Tracking Study Physician Survey data from 1996-2005 to model the impact of overtime pay on sex-based wage gaps. As overtime premiums increased in our models, sex-based wage disparities decreased: they become statistically insignificant when overtime wages reached 0%, 32%, and 61% premiums using the ordinary least squared model and with 0%, 62%, and 55% premiums using the propensity score weighted model, for internal medicine, family practice, and pediatric physicians, respectively. We conclude that modest overtime premiums reduced sex-based hourly wage gaps for the salaried primary care physicians we examined. Future analyses of sex-based wage gaps should account for leisure time and its trade for work hours when it becomes scarce.


Armstrong, K. (2012). Methods in comparative effectiveness research. J Clin Oncol, 30, 4208-4214.
Austin, P.C. (2011). An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies. Multivariate Behav Res, 46, 399-424.
Austin, P.C., Grootendorst, P., & Anderson, G.M. (2007). A comparison of the ability of different propensity score models to balance measured variables between treated and untreated subjects: a Monte Carlo study. Stat Med, 26, 734-753.
Baker, L.C. (1996). Differences in earnings between male and female physicians. NEJM, 334, 960-964.
Bourguignon, F., & Chiappori, P.A. (1992). Collective models of household behavior: an introduction. European Economic Review, 36, 355-364.
Chavey, W.E., Medvedev, S., Hohmann, S., & Ewigman, B. (2014). The status of adult inpatient care by family physicians at US academic medical centers and affiliated teaching hospitals 2003 to 2012: the impact of the hospitalist movement. Family Medicine, 46, 94-99.
Dumontet, M., Le Valliant, M., & Franc, C. (2012). What determines the income gap between French male and female GPs - the role of medical practices. BMC Family Practice, 13, 94.
Floyd, P. (2014). Roadmap for physician compensation in a value-based world. Physician Leadership Journal, 1, 14-21.
Glass, K.P., Pieper, L.E., & Berlin, M.F. (1999). Incentive-based physician compensation models. Journal of Ambulatory Care Management, 22, 36-46.
Gravelle, H., Hole, A.R., & Santos, R. (2011). Measuring and testing for gender discrimination in physician pay: English family doctors. Journal of Health Economics, 30, 660-674.
Hanoch, G. (1965). The 'backward-bending' supply of labor. Journal of Political Economy, 73, 636-642.
Kehrer, B.H. (1976). Factors affecting the incomes of men and women physicians: an exploratory analysis. Journal of Human Resources, 11, 526-545.
Kocher, R., & Sahni, N.R. (2011). Hospitals' race to employ physicians - the logic behind a money-losing proposition. NEJM, 364, 1790-1793.
Leigh, J.P., Tancredit, D., Jerant, A., & Kravitz, R.L. (2010). Physician wages across specialties: informing the physician reimbursement debate. Archives of Internal Medicine, 170, 1728-1734.
Lo Sasso, A.T., Richards, M.R., Chou, C., & Gerber, S.E. (2010). The $16,819 pay gap for newly trained physicians: the unexplained trend of men earning more than women. Health Affairs, 30, 193-201.
MGMA (2011). Medical Directorship and On-Call Compensation Survey: 2010 Report Based on 2009 Data. Englewood, CO: Medical Group Management Association.
Mitchell, J.B. (1984). Why do women physicians work fewer hours than men physicians? Inquiry, 21, 361-368.
O'Malley, A.S., Bond, A.M., & Berenson, R.A. (2011). Rising hospital employment of physicians: better quality, higher costs? Center for Health System Change Issue Brief, 136, 1-4.
Oaxaca, R.L. (1973). Male-female wage differentials in urban labor markets. International Economic Review, 14, 693-709.
Oaxaca, R.L., & Ransom, M.R. (1999). Note: Identification in detailed wage decompostions. The Review of Economics and Statistics, 81, 154-157.
Ohsfeldt, R.L., & Culler, S.D. (1986). Differences in income between male and female physicians. Journal of Health Economics, 5, 335-346.
Rizzo, J.A., & Blumenthal, D. (1996). Is the target income hypothesis an economic heresy? Medical Care Research and Review, 53, 243-265.
Scheiber, N. Obama sets rule change to expand overtime (page B1). The New York Times. New York, New York.
Staiger, D.O., Auerbach, D.I., & Buerhaus, P.I. (2010). Trends in the work hours of physicians in the United States. JAMA, 303, 747-753.
US Department of Labor. Wage and Hour Division, United States Department of Labor: Overtime Pay. Washington, DC.
Weeks, W.B., Paraponaris, A., & Ventelou, B. (2013). Sex-based differences in income and response to proposed financial incentives among general practitioners in France. Health Policy, 113, 199-205.
Weeks, W.B., Wallace, T.A., & Wallace, A.E. (2009). How do race and sex affect the earnings of primary care physicians? Health Affairs, 28, 557-566.




How to Cite

Weeks, W. B., & Ventelou, B. (2017). Exploration of Leisure Time Valuation to Explain Sex-Based Wage Gaps among Salaried Primary Care Physicians in the US. Journal of Reviews on Global Economics, 6, 395–403. https://doi.org/10.6000/1929-7092.2017.06.41