Despite a possible physician shortage in the coming years, female physicians remain underpaid compared to male physicians. Data published by the Medical Group Management Association in 2010 and a study published in Health Affairs in Feb., 2011 both found male physicians earn more than their female counterparts. What is the cause of this discrepancy and how can it be eliminated? Pediatric otolaryngologist Linda Brodsky, MD, founder and president of Expediting The Inevitable, an organization promoting gender equality in healthcare, shares insight into how hospitals and health systems can narrow the gap in pay between male and female physicians.
Challenges
One of the greatest challenges to gaining fair compensation for women is getting people to understand that there are real differences in salary, according to Dr. Brodsky. While she believes this challenge is starting to be overcome, some people continue to explain away demonstrated differences by pointing to variation in productivity, specialty and hours despite studies that have controlled for these variables.
Another major challenge is salary negotiations. Dr. Brodsky says employers may experience emotional dissonance when they expect women to be submissive but the women negotiate aggressively; this violation of expectation may cause the employer to not offer fair pay. "As soon as [female physicians] are demanding, they are looked at as not easy to work with and end up getting less," Dr. Brodsky says. On the other hand, if women meet the expectations of those employers by being passive, they will also most likely not be compensated fairly. Through a combination of acquiring new skills and changing the culture of healthcare, however, female physicians can earn fair market value for their work.
New skills
"Physicians are not very good business people," Dr. Brodsky says. Female physicians may therefore need to learn some business techniques to earn compensation that is commensurate with male physicians. Learning new negotiating skills, for instance, can help women earn more equitable pay. Using the same negotiating techniques as men will not suffice, partly because of the possible emotional dissonance of the employer. Instead, Dr. Brodsky says developing an approach that is assertive but less directly confrontational than that of men can be effective in salary negotiations. Another tactic is to gather data on salaries of physicians in similar positions to use in compensation conversations with employers. "We need to be able to get that information in an easy way so that when a job is offered, we have a fair basis for comparison and there is a degree of transparency," Dr. Brodsky says.
In addition to learning new skills for the workplace, female physicians may have to learn skills for life outside work that will support their career. Dr. Brodsky says one strategy that helped her to succeed as a mother, educator and physician was hiring a live-in housekeeper. "As residents we had very little money, but [I] thought the extra help was important. That's what worked for me," she says. "You have to figure out in your home life the things that support your needs. And remember, you don't have to be an E-woman: everything to everyone everywhere every time."
Culture
By itself, learning new skills will not be able to change a trend of pay discrepancy between the sexes that has been true not only in healthcare, but in most industries, for years. "The other solution, which I think is the broader and more difficult solution, but the only way things are really going to change, is to change the system and culture of medicine," Dr. Brodsky says. A change this big will call for healthcare organizations to alter both the structure of business and attitudes toward female physicians.
Dr. Brodsky says the healthcare workplace will need to become much more responsive to female physicians. For example, something that helped her be an effective surgeon is the flexibility her employer allowed her in terms of work hours. "This change in culture is going to require that organizations and institutions take a very hard look at how they are able to adapt to the changing healthcare workforce," Dr. Brodsky says. Organizations need to "adapt to what is just inevitable. A lot of medical students are women. [They need to] face up to that fact."
Dr. Brodsky suggests fairly compensating female physicians will help not only female physicians, but everyone in healthcare. "If you feel valued, you work harder and you're more productive. Everybody benefits."
Learn more about Expediting The Inevitable.
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Challenges
One of the greatest challenges to gaining fair compensation for women is getting people to understand that there are real differences in salary, according to Dr. Brodsky. While she believes this challenge is starting to be overcome, some people continue to explain away demonstrated differences by pointing to variation in productivity, specialty and hours despite studies that have controlled for these variables.
Another major challenge is salary negotiations. Dr. Brodsky says employers may experience emotional dissonance when they expect women to be submissive but the women negotiate aggressively; this violation of expectation may cause the employer to not offer fair pay. "As soon as [female physicians] are demanding, they are looked at as not easy to work with and end up getting less," Dr. Brodsky says. On the other hand, if women meet the expectations of those employers by being passive, they will also most likely not be compensated fairly. Through a combination of acquiring new skills and changing the culture of healthcare, however, female physicians can earn fair market value for their work.
New skills
"Physicians are not very good business people," Dr. Brodsky says. Female physicians may therefore need to learn some business techniques to earn compensation that is commensurate with male physicians. Learning new negotiating skills, for instance, can help women earn more equitable pay. Using the same negotiating techniques as men will not suffice, partly because of the possible emotional dissonance of the employer. Instead, Dr. Brodsky says developing an approach that is assertive but less directly confrontational than that of men can be effective in salary negotiations. Another tactic is to gather data on salaries of physicians in similar positions to use in compensation conversations with employers. "We need to be able to get that information in an easy way so that when a job is offered, we have a fair basis for comparison and there is a degree of transparency," Dr. Brodsky says.
In addition to learning new skills for the workplace, female physicians may have to learn skills for life outside work that will support their career. Dr. Brodsky says one strategy that helped her to succeed as a mother, educator and physician was hiring a live-in housekeeper. "As residents we had very little money, but [I] thought the extra help was important. That's what worked for me," she says. "You have to figure out in your home life the things that support your needs. And remember, you don't have to be an E-woman: everything to everyone everywhere every time."
Culture
By itself, learning new skills will not be able to change a trend of pay discrepancy between the sexes that has been true not only in healthcare, but in most industries, for years. "The other solution, which I think is the broader and more difficult solution, but the only way things are really going to change, is to change the system and culture of medicine," Dr. Brodsky says. A change this big will call for healthcare organizations to alter both the structure of business and attitudes toward female physicians.
Dr. Brodsky says the healthcare workplace will need to become much more responsive to female physicians. For example, something that helped her be an effective surgeon is the flexibility her employer allowed her in terms of work hours. "This change in culture is going to require that organizations and institutions take a very hard look at how they are able to adapt to the changing healthcare workforce," Dr. Brodsky says. Organizations need to "adapt to what is just inevitable. A lot of medical students are women. [They need to] face up to that fact."
Dr. Brodsky suggests fairly compensating female physicians will help not only female physicians, but everyone in healthcare. "If you feel valued, you work harder and you're more productive. Everybody benefits."
Learn more about Expediting The Inevitable.
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