What’s up, doc?

Medicare payments to male doctors, that’s what. In total, Medicare payments to male doctors outpace payments to female doctors by 88 percent.

But this isn’t a case of unequal pay for equal work, despite the study’s headline, “Why Women Doctors Make Half of What Men Do: Medicare’s Doctor Gender Pay Gap.”

Medicare payments are set by statute and determined by Congress. The formula is complicated, but applies equally to male and female doctors. What the study found was that male doctors see more patients, practice in more expensive specialties, and perform more services per patient. The study offers some explanations for the discrepancy, like the fact that Medicare payments vary depending on geography because of the differences in cost of living and the possibility that female doctors practice in less affluent areas.

(Before we go any further, let’s all understand that all studies are an aggregate of individuals, each with their own experiences, motivations, faults and strengths and nothing in a study of many doctors will apply to every doctor.)

So why is there a gender pay gap? An obvious reason noted in the study is the fact male doctors work more hours, probably because many women have extra responsibilities at home. Men also far outnumber women in high paying specialty fields like cardiac, orthopedic and neurosurgery. But that doesn’t explain why male doctors order so many more services per patient than female doctors do — 93 percent more in medical oncology, for instance. In fact, there’s only one specialty of the 41 measured where female doctors outpace males in that category — pediatrics. Why would that be true? Certainly not because it’s the only specialty where female doctors see an opportunity to pad the bill a bit. If you’re a woman, the reason may seem abundantly clear to you. As a man, I suspect I know the answer but don’t feel qualified to speak on behalf of female pediatricians. I will only say that if my children were small, I would want a woman to be their doctor.

For me, the study raises an important question. I would love to see a study that correlates services per patient and patient outcomes, broken down by gender. You know I think women will lead the way in the 21st century, and I’d like to know if they’re already leading the way in practicing more effective, efficient medicine.

Speaking of medicine, here’s a special bonus item. I came across a stunning piece on the cost of prescription drugs and some common hospital procedures. If you’re Dutch, your Nexium will cost you $23. Here in the U.S., we pay an average of $215. Need heart bypass surgery? Here it costs an average of $75,000. In the backward country of Switzerland, $36,500.