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Income was adjusted for age, specialty, hours worked, time period, years in practice, practice type, and percentage of revenue from Medicare/Medicaid (from HSC physician surveys).Results White male physicians had a higher median annual income than black male physicians, whereas race was not consistently associated with median income among female physicians.In contrast with the limited evidence on race differences in physicians’ income, research on sex differences is more robust.Several large studies have shown that female physicians earn less than male physicians,10 11 even after adjustment for specialty, practice type, and hours worked.12 One study estimated that the earnings gap was about 000 in 1987-90 and about 000 in 2006-10.11 Moreover, similar sex differences exist among physician researchers and among nurses.13 14 These sex differences in income also occur internationally; male physicians in the United Kingdom make about 10% more than their female counterparts.15 16Given persistent differences by race in annual income in the overall US economy, there are reasons to be concerned that these differences persist for physicians as well.Although previous analyses of differences in income by sex have found that differences persist after adjustment for hours worked, physician specialty, and practice characteristics,12 the same might not be true for race differences.We therefore used a second source of data, which included information on physician specialty, hours worked, and practice characteristics, to supplement our analyses.For example, in 2010-13 in the ACS, white male physicians had an adjusted median annual income of 3 042 (95% confidence interval 8 670 to 7 413) compared with 8 230 (0 844 to 5 616) for black male physicians (difference 812; PNational estimates of differences in annual income between black and white physicians in the United States are limited, despite evidence from outside healthcare that black workers continue to earn less than white workers over five decades since the Civil Rights Act of 1964.1 2 For example, in 1967 the mean household income for non-Hispanic white people was 026, while for black people it was 598.

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The primary strength of the HSC physician surveys was the inclusion of a comprehensive set of characteristics of physicians and practices that probably influence income.Response rates vary from year to year but range between 93% and 98% each year.11 We analyzed surveys from 2000 to 2013, the most recent year of the survey.Each survey respondent self reported information on age, sex, race, occupation, annual earned income, and weekly hours usually worked (based on hours worked at all jobs).It is important to identify race and sex differences in the earnings of physicians to highlight the magnitude of the problem.Further, it is important to distinguish whether these differences are driven primarily by factors such as access to higher paying specialties to help guide policy efforts to reduce disparities.

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