Women dentists reflect on gender gap in earnings

It’s 2018. Why are we still talking about a gender pay gap?

The answer is complicated: Despite making up nearly a third of all dentists — up from 3 percent in 1982 — female dentists continue to be out-earned by their male colleagues.

According to a 2017 study from the ADA Health Policy Institute, men dentists earned 54 percent more than women in 2010. Even after controlling for observable characteristics including age and hours worked, the difference would still be 36 percent, or what the study’s authors call the “unexplained difference.”

And it’s just not dentistry — the study also looked at wages in medicine and law over a 20-year period. It found that despite accounting for observable characteristics there remain “large, unaccountable earnings differences between men and women among all three professions.”

“This has been really eye-opening for me and for my team,” said Marko Vujicic, Ph.D., HPI vice president and ADA chief economist, who was one of the study’s authors along with Thanh An Nguyen, Ph.D., and Tony LoSasso, Ph.D.

In addition to the HPI study and an April 2017 commentary in The Journal of the American Dental Association, the subject was also the focus of a webinar hosted by Dr. Vujicic that featured Dr. Carol Gomez Summerhays, ADA past president, along with expert panelists in medicine, law and gender equality.

“I wasn’t surprised by the current gap but I had no idea that men were out-earning women 2-to-1 in the ‘90s,” said Dr. Summerhays, who graduated from dental school in 1978 and entered private practice in the 1980s. She added that at the time the study came out, she and other female colleagues were also surprised.

In 1983 she opened her own practice and was fully satisfied with her career until a study club she was in got to talking about monthly production. To her surprise, the other four
dentists were all seeing twice the number of patients as she was seeing and had monthly total production/collections that were double hers.

It was an eye-opening moment for the young practitioner who spent six months working with a consultant to get systems in place, including regular staff meetings, to get her production consistent with the rest of the group.

“It just so happened that the others were male dentists but I never saw it as a male/female issue,” she said. “It was my lack of practice management knowledge and implementation.

“This is an important issue— self awareness.”

Some of the differences can be attributed to the observable differences mentioned before. In 1990, the average male dentist was 47 compared to 39 for the women. The study also looked at the percentage of dentists who were self-employed at that time and found nearly 80 percent of the men were compared to 45 percent of the women. Women also worked about four hours less a week than the men did. By 2010, men and women worked the same number of hours a week and the number of female owners was up to 50 percent while male owners had fallen to 73 percent. The wage gap still persisted.

But other characteristics such as practice style or specialty weren’t included the study, which the authors acknowledged in the JADA commentary.

“Because Medicaid reimbursement is lower than private dental insurance reimbursement, this could account for some of the gap,” wrote Dr. Vujicic along with coauthors Cassandra Yarbrough and Bradley Munson. “Similarly, there is evidence that female dentists’ practice styles, all else equal, focus more on less invasive, preventive procedures that typically are reimbursed at lower rates than surgical interventions.”

Dr. Ruth Ross Edmonds, a Nashville, Tennessee, orthodontist who has been in practice since 2000, related to that reasoning.

“I think that some women dentists overall are more conservative with treatment plans,” she said. “The reason I say that is that I’ll have patients who will have seen a male orthodontist and they’re telling me all the treatments they recommended and that’s not my approach at all. I’m more willing to forgo a procedure because I take a conservative approach.”

The JADA commentary article referenced the book “Lean In: Women, Work, and the Will to Lead” by Sheryl Sandberg, chief operating officer at Facebook, who writes how women approach work differently than men, particularly when it comes to salary negotiation.

“That isn’t something discussed prior to new dentists getting their first jobs so women may be less apt to be aggressive in this manner and just take the offer given to them,” said Dr. Andrea Fallon, a member of the ADA New Dentist Committee.

Dr. Fallon, a general dentist in Agawam, Mass., began her career in 2008 as an associate before becoming a co-owner of the practice where she worked. As an associate she recalled negotiating for her salary with a positive outcome and also said the women dentists she has hired have done the same.

Currently she and her male partner are compensated at the same level.

Dr. Summerhays wondered if women measured success differently than men.

“We have to understand how women define success. They may have more balance in life. The driving force may not be money as it has been for the baby boomers,” she said.

Dr. Emily Mattingly, a general dentist in Chillicothe, Missouri, and member of the New Dentist Committee, said as the only female partner in a five-dentist practice, she is paid less than her male partners — something she’s perfectly fine with in creating her own work-life balance. To her, this balance equals personal success.

“The trade off is that I also work fewer days per week and frequently take off extra days for my kids,” she said. “In addition, I have a shorter work day (9-4) than them all by choice.”

In Dr. Ross Edmonds’ household, she is the main breadwinner and her husband manages the household.

“When I talk to a lot of my female friends they are the main breadwinner,” she said. “Because of the role reversal they don’t have the worries or stress because someone is taking the stress away and they are able to work more. So with that being said, I feel that the gender gap might start to shrink even more.”

For more information, visit ADA.org/HPI. To read the April 2017 JADA articles, visit JADA.ADA.org and search “gender wage gap.”

5 comments

  • Dentistry is all about eating what you kill. If a Woman doc feels cheated in earning capacity, then look in the mirror.

    • Michael Colleran

      So true.

      The female dentists charge the same or more than I do. How do they not “earn” as much?

      Maybe there is something wrong with how the study looked at the numbers? Perhaps there is a bias in the way the data is labeled and manipulated?

  • Wish it were that simple…

  • I think it’s a multifactorial issue for equal pay to occur in any profession. Glad to see the ADA putting resources into this important topic to help educate all of us. As Brian Shaefer mentioned, it is about looking in the mirror, but it’s also more than that, and as each of us takes on an empathic attitude versus a blaming attitude, we will determine the solutions so that our profession will be welcoming and fair to each of us.

  • This is a huge and complex issue. Thank you for writing about this – every piece of writing about this will help move the issue further.

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