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A look into the gender gap in dentist earnings

20 September 2019

A look into the gender gap in dentist earnings

Since the first UK female dentistLilian Lindsayqualified in 1895, the number of women in dentistry has been increasing year after year. Lindsay was denied enrolment at the dental schools in England​ and therefore had to graduate from Edinburgh. 

Following her ground-breaking accomplishment, the number of female dentists in the UK has been on a steady rise and the percentage of women registered with the General Dental Council (GDC) has seen an increase from 3.2% in 1937 to 32% by the year 2000. 

Today, around 49% of dentists are women (Health & Social Care Information Centre, 2018) and taking into consideration the numbers currently at university, by 2020 over half of registered dentists will be female.1 

Do female dentists earn less than their male counterparts? 

Despite this remarkable transformation, it appears that women overall, are earning less than their male counterparts and the gender pay gap in the dentistry industry is very much still prevalent. 

Figures from the ‘Dental Earnings and Expenses Estimates 2017/18’ report​ released by the NHS earlier this month show that male dentists income was significantly higher than that of their female counterparts across the board and that, regardless of dental type classification, male dentists had higher gross earnings, total expenses and taxable income on average than their female counterparts. 

For all male self-employed primary care dentists, average taxable income was £81,900 compared to £54,700 for all female self-employed primary care dentists, which could be partly explained by the higher proportion of male dentists being Providing-Performers (top-earning dentists). 

The report also saw top-earning Providing-Performer dentists earn more than female Providing-Performer dentists by £17,100. 

However, it adds: "This report includes both full-time and part-time dental earnings and expenses, and given that on average male dentists tend to work longer weekly hours compared to their female counterparts, this could be a contributory factor to the differences observed in earnings and expenses by gender." 

It should also be noted that there are gender differences among dentists in terms of both pay and the propensity to be practice owners – women currently make up less than a quarter of Providing-Performers in the UK – and it is likely that the former is influenced by the latter. 

What does this mean for gender parity in dentistry? 

Part of any gender pay gap may be explained by factors such as the number of hours worked. There is therefore a distinction to be drawn between a ‘structural’ gender pay gap which can be accounted for by factors such as fewer working hours or more junior roles, and a discriminatory gap where equal work is not achieving equal pay – which the evidence presented to us does not distinguish between. As such, there are many potential reasons that fall into two broad buckets. 

First, the existing research could be failing to measure important characteristics of dentists that vary by sex and also drive earnings. For example, there is evidence that female dentists in the US, all else equal, are more likely to treat Medicaid (state-funded) patients than their male counterparts.2 

Because Medicaid reimbursement is lower than private dental insurance reimbursement, much like with the NHS, this could account for some of the gap. 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.3 

Secondly, female dentists may just be compensated less for the exact same work. Vujicic et al offer various explanations to this effect: “They might charge lower fees than their male counterparts. They might enter into ownership or partnership arrangements with less favourable financial terms than their male counterparts. They may accept lower compensation packages in their first job.4 

While research on these issues is difficult to come by, their informal crowdsourcing of perspectives from several dentists suggests these factors are relevant, but it is hard to get data. 

For these and a host of other reasons, dentistry must continue to attract women to the profession. Although additional research is still needed, we know enough now to motivate a deeper discussion as a profession on the gender earnings gap, and how to address it. 

With regards to further transparency in earnings, the British Dental Association (BDA) have called for an analysis of hourly pay, rather than taxable income, by gender which would better allow for a distinction to be made between inequalities resulting from structural workforce factors and those caused by unequal pay for equal work.

 

Sources: 

[1] Pacey L. Investigation: Have women changed the dental workforce? BDJ. 2014; 216(1): 4-5 

[2] Nicholson S, Vujicic M, Wanchek T, Ziebert A, Menezes A. The effect of education debt on dentists’ career decisions. JADA. 2015; 146(11):800-807. 

[3] Riley JL, Gordan VV, Rouisse KM, McClelland J, Gilbert GH. Differences in male and female dentists’ practice patterns regarding diagnosis and treatment of dental caries. JADA. 2011; 142(4):429-440. 

[4] Vujicic M, Yarbrough C, Munson B. Time to talk about the gender gap in dentist earningsJADA. 2017; 148(4): 204-205 

[5] Health & Social Care Information CentreDental Earnings and Expenses Estimates 2017/18https://digital.nhs.uk/data-and-information/publications/statistical/dental-earnings-and-expenses-estimates/2017-18/englandwales#2-percentage-of-time-spent-on-nhs-dentistry [accessed 20.9.19] 

[6] British Dental Association, Women in dentistry. https://bda.org/womenindentistry [accessed 20.9.19] 

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