Letter to the Editor of FemInEM:
Regarding: Big and Bright Ideas section of Dallas Medical Journal, vol. 104, no. 9
Some commentary in the Big and Bright Ideas section of this edition of the Journal has attracted a significant amount of attention in medical social media. A variety of opinions are expressed, but the comments by Dr. Gary Tigges, MD, are particularly noteworthy. A suggestion is made that women physicians do not get paid as much as male physicians because they do not work as hard. This has caused some consternation among the women that I know in my own specialty of Emergency Medicine. Available data suggests that women and men are equally productive given equal professional opportunity, even with claims by researchers that adjustments were made for such confounders as patients seen, hours worked and DRGs billed. Therefore, the true cause of the pay gap, that appears again and again in research on this topic, is frankly a bit mystifying. Dr. Tigges did not invent this controversy, but his comments certainly intensified an already fraught national conversation about it.
What this situation demands is compensation transparency. If all in a given group could see what all others in that group were earning, I predict there would be significantly less acrimony and suspicion of back-door secret compensation deals. Claims that women are paid less because they see less case volume per year than men, and counter-claims that men get higher hourly compensation because of secret bro-culture deals would finally be put to rest. At the very least, those making those claims would have some hard data to discuss. All that is needed is a billing company report and an accountant to attest that the numbers were accurate.
There is a problem with physician burnout in this nation at this time. If there is a national burnout problem, there is likely a national employee retention problem. If there is a national employee retention problem, then there is likely a national compensation problem.
There is a prediction of increasing numbers of women in medicine. This is a predestined future since American medical schools in aggregate have had more women than men for at least a decade. When we retire, on average we will be more likely to be looking to a woman to replace us than a man. It therefore makes sense to take all reasonable steps to make our individual practice compensation methods attractive to women in more ways than just money itself. Compensation transparency is a pretty straightforward way to make the job we are offering more attractive to competitive candidates in general, and competitive women in particular.
This is an excellent approach. When I was a practicing EP, working night shifts exclusively, I learned I was actually paid less than my counterparts because the shift was an hour shorter. Never mind that I was single coverage for most of the night, while double and triple coverage applied during day and evening shifts. There was in addition a “bonus” system that we were not allowed access to, lest we might “game the system” according to the business manager (my husband). I accidentally found out what it was, which was that every person who saw more than the mean… Read more »