Physicians enjoyed a substantial rise in mean wage growth between 2001 and 2017, while registered nurses and healthcare practitioners such as dentists and chiropractors saw a modest bounce in pay.
Meanwhile healthcare workers in two other categories—support staff (orderlies, dental hygienists) and direct patient care workers (psychologists, homecare aides)—either had negligible wage growth or considerable wage contraction.
The findings are from an analysis of the American Community Survey by Fordham University economist Janis Barry, PhD. The journal Human Resources for Health published the study Aug. 28.
Here are the unadjusted, mean hourly wages in 2001 and 2017 in order of percentage change over that timeframe as recorded by Barry:
- Physicians/surgeons: from $59.36 to $81.70 = +37.6%
- Nurses: from $29.73 to $32.68 = +9.92%
- Healthcare practitioners: from $22.68 to $23.97 = +5.68%
- Healthcare support: from $13.61 to $13.73 = +0.88%
- Direct patient care: from $21.77 to $19.94 = –8.4%
The slow or negative median wage growth in all but the physician occupation “confirms that healthcare wages in the U.S. are not recession-proof, unlike healthcare employment,” Barry reports.
At the same time, Barry found women’s earnings grew at higher or less negative rates than those found for men.
“This trend contributed to narrowing the gender pay gap in every occupation except for nurse,” she points out. … “Overall, men in healthcare support registered a negative cumulative wage change, while women experienced wage stagnation.”
However, there was a catch to the win for women. Clear gains notwithstanding, pay disparities between the sexes in nursing and medicine “signal the limitations placed on women’s decision-making, promotion and training opportunities,” Barry comments.
There’s also persistent male/female unevenness in primary care. Barry cites previous research documenting the tendency of women PCPs to spend more time with patients.
“More extended face-to-face interactions mean fewer office visits and lower employer revenues, resulting in pay reductions for female physicians,” Barry comments. “Compensation schemes that discount the value of care services force women to choose between commitment or bargaining for pay.”
More:
Nurses want respect and collaboration from doctors, the ability to practice at the top of their license, sound referral systems and adequate resources. But the market has historically devalued skills demanding empathy, dedication and intrinsic motivation, which form a large part of gendered care service provision. This contributes to the unequal pay between men and women for comparable work in nursing, medicine and the allied professions.”
As for the negative wage growth for direct patient care employees, Barry calls this finding “surprising”—especially considering the number of skilled and credentialed workers in this category.
One explanation lies in the increased percentage and wide swath of these jobs lumped together as “other” by the U.S. Census Bureau, which annually conducts the American Community Survey.
In addition:
Higher-paid workers such as psychologists and health services managers face a wage ‘ceiling effect’ in the public sector. Were these jobs located in the private sector, they would pay more. Additionally, approximately one-third of the direct patient care category was composed of home/personal care aides in 2017. These jobs are the lowest paid and least regulated in healthcare.”
The study is available in full for free.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.