美国哈佛医学院Anupam B Jena团队对执业医师性别构成与医师收入性别差异进行了一项观察性研究。2020年7月30日，该研究发表在《英国医学杂志》上。

为了评估男女医师之间的收入差异是否因执业医师的性别组成而有所不同，研究组进行了一项回顾性观察研究，对2014-2018年全美医师的薪资进行调查。研究组共招募了9848个团体诊所的18802名医师，按男性医师占比≤50%,、>50-75%,、>75-90%和>90%分层。在对医师专业、工作年限、工作时间、临床工作量、执业类型和地理位置进行多变量校正后，探讨医师收入性别差异与执业医师性别构成的相关性。

在11490位非外科专家中，男性占50%以下的执业医师队列中，年收入校正后的绝对性别差异为36604美元；男性占90%以上的执业医师队列中则高达91669美元。在3483名外科专家中也有类似发现，男性占50%以下的执业医师队列中，年收入校正后的绝对性别差异为46503美元；男性占90%以上的执业医师队列中则高达149460美元。而在3829例初级保健医师中，收入性别差异与执业医师中男性医师的比例无关。

总之，在非外科和外科专家中，男性医生比例最高的执业医师中，收入的性别差异最大，即使进行了多因素详细校正后依然如此。

附：英文原文

Title: Practice composition and sex differences in physician income: observational study

Author: Christopher M Whaley, Daniel R Arnold, Nate Gross, Anupam B Jena

Issue&Volume: 2020/07/30

Abstract: Objective To assess whether differences in income between male and female physicians vary according to the sex composition of physician practices.

Design Retrospective observational study.

Setting US national survey of physician salaries, 2014-18.

Participants 18802 physicians from 9848 group practices (categorized according to proportion of male physicians ≤50%, >50-75%, >75-90%, and >90%).

Main outcome measures Sex differences in physician income in relation to the sex composition of physician practices after multivariable adjustment for physician specialty, years of experience, hours worked, measures of clinical workload, practice type, and geography.

Results Among 11490 non-surgical specialists, the absolute adjusted sex difference in annual income (men versus women) was $36604 (￡29663; €32621) (95% confidence interval $24903 to $48306; 11.7% relative difference) for practices with 50% or less of male physicians compared with $91669 ($56587 to $126571; 19.9% relative difference) for practices with at least 90% of male physicians (P=0.03 for difference). Similar findings were observed among surgical specialists (n=3483), with absolute adjusted sex difference in annual income of $46503 ($42198 to $135205; 10.2% relative difference) for practices with 50% or less of male physicians compared with $149460 ($86040 to $212880; 26.9% relative difference) for practices with at least 90% of male physicians (P=0.06 for difference). Among primary care physicians (n=3829), sex differences in income were not related to the proportion of male physicians in a practice.

Conclusions Among both non-surgical and surgical specialists, sex differences in income were largest in practices with the highest proportion of male physicians, even after detailed adjustment for factors that might explain sex differences in income.

DOI: 10.1136/bmj.m2588

Source: https://www.bmj.com/content/370/bmj.m2588