Commit to a conversation about the gender pay gap

The gender pay gap is a hot-button issue among women physicians. A few years ago at a local women physicians group meeting, I listened in awe as a gynecologist discussed interviewing for a job early in her career. She and her male co-resident were under consideration for the same position. Upon touching base with her colleague after the interview, she realized he was offered significantly more: on the order of $50,000 more a year. Sounds like a historical relic, a dated case of gender discrimination in the medical profession. Sadly enough, this thinking is much too optimistic. In 2018, the gender pay gap remains very real.

Despite female medical students now outnumbering males in classrooms across the U.S., the income gap between male and female physicians is widening. A recent study from the Center for Health Workforce Studies at SUNY Albany highlighted the doubling of the income gap between newly graduated male and female physicians from 2010 to 2016. Male physicians fresh out of training in 2016 had a starting salary that was $26,367 more than their female counterparts. In 2010, this difference was $11,931.

Perhaps the New York data is an anomaly. A look at the national data, unfortunately, shows otherwise. Data from The National Census Bureau in 2015 confirmed that women physicians make $62,497 less than their male counterparts, or 69 cents for every dollar earned. The 2017 Medscape Physician Compensation Report showed this gap to be wider for specialists than their primary care colleagues. In their self-reported survey, men in primary care made $32,000 more than their female colleagues while male specialists outearned their female counterparts by $95,000.

These sobering numbers have led some prominent physicians advocating for pay equity to call for department-wide salary audits. But, how does this translate for physicians practicing independently in the community, not affiliated with a university hospital? On our National Physician Moms Group, a closed Facebook community with over 71,000 female physician members, questions are regularly posed regarding contracts and compensation packages. Many women chime in with their experience and advice, often referencing national Medical Group Management Association data in a particular specialty to give a launching point for negotiations.

Surprisingly, I observed something very interesting this past week in a smaller yet still closed, or private, Facebook group for local women physicians. A doctor asked about average starting salaries in pediatrics in our local area. The answer: radio silence. In the silence, I could almost imagine each woman debating the appropriateness of “publicly” sharing their personal salary information. Two pediatricians answered and a third offered to discuss privately off the forum. While certainly any information is helpful, it is this exact mindset that keeps women physicians ill-informed of what to expect in terms of compensation. There is a culture in medicine of not openly discussing salary. And it needs to end.

If we want to close the gender salary gap, we need to be intentionally transparent when it comes to salaries and benefits. This does not need to be a public declaration. But in a private Facebook group or while advising a colleague over coffee or even when mentoring a trainee in the clinic, these conversations are necessary. Knowledge is power. How can we expect female trainees to approach negotiation if the target is invisible? Without these necessary, albeit uncomfortable, conversations, we are leaving future women physicians to fumble in the dark at the negotiating table with night vision goggles only available to those on the other side.

Pay it forward to the next generation of women physicians: Commit to a conversation about the gender pay gap. When female colleagues ask about what to expect for pay in a specific field on a private forum or closed group, boldly reply knowing you are helping our future generation of women in medicine. Intentionally discuss this topic with trainees. Behind each physician negotiating her salary, let there be a band of other women physicians arming her with information and silently cheering her on. We can whittle away at the gender pay gap in medicine one bold conversation at a time.

Lauren Kuwik is an internal medicine physician who blogs at the Pensive Physician and can be reached on Twitter @lauren_kuwik.

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