A study looked at how much black doctors and white doctors get paid, and guess who's getting screwed?

By now we all know that the pay gap is worse for women of color. And we know that people of color are routinely left out of clinical trials for medications. And that people of color face substantial health disparities when compared to their white peers.

But now—sigh—we also know there’s another way people of color, and women of color in particular, take a hit when it comes to both healthcare and income: A new study out of Harvard has found that physician salaries are hugely impacted by both race and gender.

Researchers found that, after adjusting for age, hours worked, specialty, years in practice, and percentage of revenue earned from Medicare and Medicaid reimbursements, white male physicians earn, on average, $253,042 annually. In comparison, black male physicians earn an average of $188,230 annually, white female physicians earn $163,234 annually, and black female physicians earn an average of $152,784 annually.

Yes, you read that right: A white male doctor in the same field and with the same amount of years of practice and area of specialty and hours worked will, on average, make $100,000 more a year than a black female colleague.

“It’s well known that substantive wage gaps exist across race and sex in the overall U.S. economy,” says Dr. Anupam B. Jena, one of the study’s authors and an associate professor at Harvard Medical School, “but the extent to which medicine has been spared of these issues, at least when it comes to race, has been largely unknown.” He and his team aimed to provide some answers.

And indeed, sadly, the 2015 Bureau of Labor Statistics report on the median weekly age and salary of workers by occupation and sex found that male physicians and surgeons make a median amount of $1,915 weekly, compared to a $1,533 weekly median wage earned by female physicians and surgeons.

Race is not factored into this data—but if it were, the findings would clearly be jaw-dropping.

As the American Association of University Women notes, “while education improves take-home pay for everyone, African American and Hispanic women tend to be paid less than their white peers even when they have the same educational background. This tells us that educational background isn’t the whole story.”

And research done in 2014 by Northwestern University’s Kellogg School of Management found that not only are black job seekers offered less compensation than white job seekers, but that they were also more likely to accept lower offers than white peers. Over time, the researchers found, employers were likely to raise wages for black employees after observing their job performance—but the amount of lost wages over a lifetime adds up. And meanwhile, each new hire starts the vicious cycle of discrimination all over again.

In 2013, the Center for American Progress presented data showing that black women earn, on average, 64% of what their white, non-Hispanic male peers make. However, this wage gap, as CAP points out, is frequently attributed to the fact that women of color are more likely than white women, as well as white men, to be shut-out of higher paying fields and forced into lower-earning ones such as those in the service industry or sales. In 2014, CAP reports, only 35% of black women were employed in higher-paying management or professional jobs.

Which is why the newly released Harvard study is especially disturbing: Even when black women are able to gain access, against all the systemic odds, to professional fields like medicine, they’re still paid less. And seemingly for no reason other than the color of their skin and their gender identity.

As Dr. Jena points out, the gender pay gap in medicine can, in part, be attributed to the fact that men and women often end up in different specialties. “We found that race and sex differences in specialty choice, location of practice, hours worked, and insurance case-mix explain some of the gap but even accounting for these factors, a gap remains,” he says. But the reasons why physicians end up in certain specialities isn’t always clear cut. “To the extent that black and female physicians’ choices about specialty reflect institutional limitations to access rather than pure preferences, this is an issue that needs addressing,” Jena explains. “At the very least, it merits serious investigation.”

Let’s hope that investigation happens sooner rather than later.

Jen Gerson Uffalussy is a regular contributor to Fusion. She also writes about reproductive and sexual health/policy for Glamour, and television for The Guardian. She lives in Atlanta.