The quote appeared in the “Big and Bright Ideas” section of the September edition of the journal as part of a feature asking industry professionals to share their thoughts and potential solutions to the gender pay gap in medicine.
Tigges's contribution: “Female physicians do not work as hard and do not see as many patients as male physicians. This is because they choose to, or they simply don't want to be rushed, or they don't want to work the long hours."
An internist at Plano Internal Medicine Associates, Tigges went on to write that women tend to care more about outside obligations than work. The pay difference, he said, is a natural consequence.
"Nothing needs to be 'done' about this unless female physicians actually want to work harder and put in the hours,” Tigges wrote. “If not, they should be paid less."
Male and female doctors alike called out the remarks as sexist and ignorant. “These kinds of views … are not supported by actual data,” tweeted Esther Choo, physician and founder of the gender-equity consulting firm Equity Quotient. “This doctor is not only wrong, he's part of the problem,” tweeted Jorge Montoya, a cardiologist in Mexico.
Men in medicine often earn 20 to 30 percent more than their female counterparts, research shows. And the gap may be widening. A study released in March from Doximity, a social networking platform for health-care professionals, examined compensation data from more than 65,000 doctors across 40 specialties and found that female doctors earned 27.7 percent less on average than their male counterparts in 2017, amounting to $105,000 less a year.
Tigges did not immediately respond to a request for comment. But he told the Dallas Morning News late last week that his comments were taken out of context and that he didn't know they were going to be published.
"My response sounds terrible and horrible and doesn't reflect what I was really trying to say,” Tigges said. “I'm not saying female physicians should be paid less, but they earn less because of other factors."
Tigges, originally from Iowa, founded Plano Internal Medicine Associates in 1996, according to the practice's website. He has held several leadership positions at Presbyterian Hospital of Plano and has served on councils for the Texas Medical Association.
Doctors are paid in proportion to the number of patients they see, Tigges said, pointing to data suggesting that women work shorter shifts and deal with fewer patients because of other obligations, the Dallas Morning News reported.
On Sunday he apologized in a statement posted on his practice's website.
"I have heard from several trusted female physician colleagues who disagree with and are deeply hurt and offended by the comments," he said. "I sincerely apologize to all female physicians for my comments and the pain they have caused."
Many female doctors do work fewer hours and see fewer patients, but not because of laziness or lack of drive, according to studies from the Annals of Internal Medicine and the American Medical Association. Female physicians shoulder more of the burden at home; those with kids work an average of 11 fewer hours a week than ones without, according to a 2017 study by JAMA Internal Medicine. Their extra burdens at home are used against them — to justify their lower pay and elevate men's higher pay, according to Kim Templeton, a professor of orthopedic surgery at the University of Kansas Medical Center in Kansas City.
"Some people have said women doctors don't see as many patients as male doctors because they have other responsibilities at home with kids. That's why they make less,” Templeton told CNN Money. “Decades later, the assumption is that [male doctors] should make more because they are taking care of the family."
The myriad responsibilities female doctors often bear can take a heavy toll. Far more female physicians grapple with burnout, according to Susan Thompson Hingle, a professor at the Southern Illinois University School of Medicine. This leads many to switch careers at a time when the United States stares down a troubling doctor shortage — with the nation potentially lacking 120,000 physicians across various specialties by 2030, according to recent data from the Association of American Medical Colleges. Women in medicine are also more likely to deal with depression and are twice as likely as the general population to commit suicide, according to a 2018 study by Louise Andrew.
Despite these factors, denial of the gender pay gap and the struggles faced by women are common, Gabriela Zandomeni, a Dallas physician and chair of the committee that publishes the Dallas Medical Journal, said in a statement on Saturday. The committee chose to publish Tigges's comments because his perspective is common, Zandomeni said, and needs to be dealt with out in the open.
She wrote that she was also outraged by the opinions claiming that a gender pay gap doesn't exist. But the problem isn't in what one doctor thinks, she said, noting, “The danger is in the physicians who think this but do not express it, or who justify it."
The Dallas Medical Journal asked readers to submit reactions to the opinions about the gender pay gap from this month’s issue and will publish a “representative sample” next month.