I gained a certain notoriety last summer by suggesting in a New York Times op-ed that it isn’t a good thing for growing numbers of physicians to work part time. American-trained physicians have an obligation, it seems to me, to make full use of our professional skills because there is a shortage of doctors and because American taxpayers provide so much of the funds for our training. Now, in a new article in the Atlantic magazine–“Is Medical School a Worthwhile Investment for Women?”–two Yale professors suggest that physicians might as well work full time or more because, if we don’t, medical school is an investment of time and money that doesn’t make financial sense.
This article didn’t surprise me at all. It specifically points to the example of American primary care doctors who are less well compensated than specialists. Using a tool called net present value (NPV) calculation, Professors Keith Chen and Judith Chevalier compared the costs of earning a degree against the income earned over the likely course of a career. They compared the NPV of training as a physician assistant (PA) compared to a primary care physician, and also looked at gender differences in anticipated earnings.
Their conclusion? “We found that, for over half of woman doctors in our data, the NPV of becoming a primary-care physician was less than the NPV of becoming a physician assistant,” the authors wrote.
Was this true for men as well? No, said the authors. Most men are better off financially if they become physicians. But women physicians tend to earn less than their male counterparts, and they also tend to work less. A male physician “earns more per hour relative to the male PA than the female doctor earns relative to the female PA,” the authors noted. “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.”
The professors concluded, “Even though both male and female doctors 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.”
After reading the Atlantic article, I don’t doubt the reasoning behind it but have other questions to raise.