Specialty, work effort, and gender have been shown to be associated with physicians’ annual incomes. Although female plastic, oral, and cardiothoracic surgeons have been shown to have lower incomes than their male counterparts, differences in incomes attributable to gender or race among general surgeons have not been evaluated.

We used survey responses collected during the 1990s from 771 actively practicing general surgeons and linear regression modeling to determine the association of race and gender with general surgeons’ annual incomes after controlling for work effort, provider characteristics, and practice characteristics.

Compared with Caucasian men, both African-American male and Caucasian female general surgeons reported having fewer patient visits (10% fewer and 17% fewer, respectively), but working more annual hours (14% more and 6.7% more, respectively). Caucasian women were more likely than the other groups to be nonpractice-owner employees. African-American men and Caucasian women were less likely than their Caucasian male counterparts to be board certified. After adjustment for work effort, provider characteristics, and practice characteristics, African-American mens’ mean annual income was $248,048, or $49,205 (17%) lower than that for Caucasian men (95% CI: $129,645 lower to $31,236 higher, p=0.2); Caucasian womens’ was $233,397, or $63,856 (21%) lower (95% CI: $120,367 to $7,345 lower, p=0.03).

During the 1990s, among Caucasian general surgeons, female gender was associated with considerably lower annual incomes; among male general surgeons, African-American race was associated with lower annual incomes, but not substantially so. These findings warrant additional exploration to ensure that income differences among physicians are not unjustly determined by race or gender.