Race and gender differences in general internists' annual incomes.

BACKGROUND: Specialty, work effort, and female gender have been shown to be associated with physicians' annual incomes; however, racial differences in physician incomes have not been examined.
OBJECTIVE: To determine the influence of race and gender on General Internists' annual incomes after controlling for work effort, provider characteristics, and practice characteristics.
DESIGN: Retrospective survey-weighted analysis of survey data. PARTICIPANTS: One thousand seven hundred and forty-eight actively practicing General Internists who responded to the American Medical Association's annual survey of physicians between 1992 and 2001. MEASUREMENTS: Work effort, provider and practice characteristics, and adjusted annual incomes for white male, black male, white female, and black female General Internists.
RESULTS: Compared with white males, white females completed 22% fewer patient visits and worked 12.5% fewer hours, while black males and females reported completing 17% and 2.8% more visits and worked 15% and 5.5% more annual hours, respectively. After adjustment for work effort, provider characteristics, and practice characteristics, black males' mean annual income was 188,831 dollars or 7,193 dollars (4%) lower than that for white males (95% CI: -31,054 dollars, 16,669 dollars; P=.6); white females' was 159,415 dollars or 36,609 dollars (19%) lower (95% CI: -25,585 dollars, -47,633 dollars; P<.001); and black females' was 139,572 dollars or 56,452 dollars (29%) lower (95% CI: -93,383 dollars, -19,520 dollars; P=.003).
CONCLUSIONS: During the 1990s, both black race and female gender were associated with lower annual incomes among General Internists. Differences for females were substantial. These findings warrant further exploration.