Archive for August 2nd, 2012

August 2, 2012

Better financial payoff for women who become PAs instead doctors

by Grace

The average female primary-care physician would have been financially better off becoming a physician assistant.

When a net-present-value (NPV) calculation was applied to cases where women chose to become physician assistants (PA) and compared to those who chose to become primary-care doctors, the average economic outcome was found to be superior for those who chose the PA career path.  The upfront costs, deferred earnings during training, hourly earnings, and lower PA salaries are all factors in this equation.  One factor that appears to make the biggest difference in outcomes for women is the lower number of hours they work compared to men.

… Male doctor earns more per hour relative to the male PA than the female doctor earns relative to the female PA. However, a big part of the difference comes from an hours gap. The vast majority of male doctors under the age of 55 work substantially more than the standard 40 hour work week. In contrast, most female doctors work between 2 to 10 hours fewer than this per week.

Even though both male and female doctors both earn higher wages than their PA counterparts, most female doctors don’t work enough hours at those wages to financially justify the costs of becoming a doctor.

The medical profession is one that lends itself to women (or men) scaling down to part-time schedule, an option preferred by most working mothers.  So it is should not be surprising that women doctors rarely drop out of the work force.

… there is evidence that women doctors actually “drop out” less frequently than women lawyers and (especially) women MBAs. For example, a 2010 study by Herr and Wolfram find that in a sample of Harvard graduates, 94 percent of mothers with MDs remain working in their late 30s, compared to only 79 percent of JDs and 72 percent of MBAs. One of the attractive features of primary care medicine is the possibility to scale up or scale down the workload — flexibility often not feasible for an executive or investment banker. If one scales down enough, though, the upfront investment of becoming a doctor isn’t recouped.

The fact that most female doctors work “between 2 to 10 hours fewer” than a standard 40-hour work week in contrast to male doctors who work substantially more hours helps explain why many female doctors I’ve encountered tend to keep shorter office hours and are less available after hours.

… in 1976 women constituted only 24 percent of first year medical students. By 2006, that number which doubled to 48 percent.

The rising trend in female doctors who will continue to work fewer hours may exacerbate the shortage of doctors, which is expected to worsen as the result of demographic changes and the implementation of Obamacare.

Considering these trends, what are some possible future scenarios?

  1. Women doctors will begin to work longer hours as more fathers take on the role of primary child care.
  2. Fewer women will choose medical school and instead opt for the PA career route.
  3. More of our medical care will be handled by PAs instead of doctors.
  4. All of the above

Some background on the PA profession

… Physician assistants (PAs) are medical professionals who diagnose and treat illness under the supervision of a physician and who may, in all 50 states and the District of Columbia, write prescriptions. The first PA program started in 1965 at Duke University, and was initially designed to provide civilian medical training to field medics returning from Vietnam.

Interestingly, while the PA field started out all male, the majority of graduates today are female. The PA training program is generally 2 years, shorter than that for doctors. Unsurprisingly, subsequent hourly earnings of PAs are lower than subsequent hourly earnings of doctors.

The 2010 median pay for PAs was $86,410 per year.  It might not be a bad career choice for either men or women.

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