Report highlights wide pay gap for women, minorities in medicine
The Association of American Medical Colleges, or AAMC, recently published the first-ever, national-level analysis of full-time faculty salaries in academic medicine by gender, race and ethnicity.
The analysis, which reflects the compensation of 60,000 physicians at academic institutions throughout the U.S., showed that women physicians across races and ethnicities were paid between $0.67 and $0.77 on the dollar compared with white men. Additionally, women physicians, regardless of race or ethnicity, earned less than men of every race and ethnicity.
“This report is the first of its kind within health care; it’s a large-scale assessment of physician compensation through the intersectional lens of gender, race and ethnicity,” Amy S. Gottlieb, MD, FACP, chief faculty development officer at Baystate Health and associate dean for faculty affairs and professor of medicine and OB/GYN at UMass Chan Medical School–Baystate, said during an interview with Healio. “A tremendous amount of work has gone into the creation of this landmark report, and it is worth reviewing, talking about and publicizing as a valued resource for our profession.”
Gottlieb spoke with Healio about the report’s findings, ways to narrow the gender pay gap and the knowledge that women and institutions can glean from a book she wrote on the topic.
Healio: What prompted the AAMC report?
Gottlieb: The AAMC collects compensation data from its member organizations and produces an annual faculty salary survey that most U.S. medical institutions rely on for salary benchmarking. In 2019, two AAMC staff members — Valerie Dandar and Diana Lautenberger — led an effort to look at these data through a gender lens and then in 2021 to assess by gender, race and ethnicity.
Healio: Were you surprised by any of the report’s findings?
Gottlieb: Not at all. The findings echo trends we have seen in the U.S. labor market as a whole.
Healio: What can be done to narrow the pay gap?
Gottlieb: The gender pay gap in medicine is a crucible in which the forces that diminish women’s professional value within our medical institutions converge. Medicine’s traditional way of valuing professional contributions disproportionately rewards the way men physicians and faculty have worked and lived for generations. Typical compensation methodology is driven by opportunities, like formal leadership roles and senior academic rank, that tend to accrue to men and by activities, like salary negotiation, that have been shown consistently to favor men and penalize women. At the same time, this compensation calculus fails to account for organizational citizenship and health care quality, endeavors in which women tend to excel. For more information, please see “Closing the Gender Pay Gap in Medicine,” an article my colleague, Reshma Jagsi, MD, DPhil, of University of Michigan, and I wrote that was published in October in The New England Journal of Medicine.
To narrow the gender pay gap, institutional leaders and their colleagues in human resources and finance will need to scrutinize the basic assumptions that underly their compensation methodologies to understand the expectations and outcomes they generate and then build frameworks that account for women’s unique contributions and the biases facing them.
Healio: What knowledge can organizations gain from your book: Closing the Gender Pay Gap in Medicine: A Roadmap for Healthcare Organizations and the Women Physicians Who Work for Them?
Gottlieb: The book focuses on systems-based change and offers a detailed roadmap for health care leaders seeking to close the gender pay gap at their institutions. In short, organizations will need to identify, acknowledge and address the contextual forces at play in their compensation models if they are going to correct the practice of paying equally talented women physicians and faculty less than their male counterparts. The first step will be to conduct salary audits to understand where women fall relative to the institution’s target salary benchmarks compared with male colleagues. Additionally, it will be critical to explore the metrics that are driving compensation and consider disparities inherent in attaining them. Organizations will also need to adopt processes that support equity, such as standardizing salary benchmarks for new hires and requiring reviews for compensation offers that are above or below those standards. Lastly, institutions must expect unconscious bias training for everyone involved in recruiting, hiring, evaluating, promotion and salary setting to help build cultures in which women and men are not limited by implicit role expectations.
Healio: What can women do?
Gottlieb: Responsibility for closing the gender pay gap in medicine rests primarily with organizations and their leaders. Eliminating salary disparities will require cultural and operational change. That being said, until organizations fully undertake this endeavor, there are efforts women can make to support being paid equitably. Most critically, women physicians and faculty need to know their worth. Specifically, they should be knowledgeable about institutional salary benchmark target ranges and the metrics that determine where one falls in those ranges. They should also know what the fair market value is for their role, specialty and rank based on reputable salary survey sources like the AAMC’s Faculty Salary Survey.
Healio: Is there anything that you would like to mention?
Gottlieb: So much has been written about the problem of the gender pay gap in medicine; however, a robust discussion about how to rectify the situation has been missing from the conversation. The book and the recent NEJM article elucidate how cultural expectations and traditional compensation methodology in medicine work together to perpetuate salary inequities and also provide concrete solutions to mitigate these phenomena to close the gender pay gap.
References:
- AAMC. Exploring faculty salary equity at U.S. medical schools by gender and race/ethnicity. Available at: https://store.aamc.org/exploring-faculty-salary-equity-at-u-s-medical-schools-by-gender-and-race-ethnicity.html. Accessed Nov. 4, 2021.
- Gottlieb AS and Jagsi R. N Engl J Med. 2021;doi:10.1056/NEJMp2114955.
For more information:
Amy S. Gottlieb, MD, FACP, can be reached at amy.gottliebmd@baystatehealth.org.
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