Gender Pay Gap

[Lordosis]

People in an employed model usually work for $/wRVU. This is something that can be negotiated. If men are better at negotiating (not at medicine!) then they could make dollars more/wRVU, which would account for some gender pay gap.

Are men better at negotiating? This has not been the case in my experience!

Joking aside is there data on this? Seems like low hanging fruit if true.

[The White Coat Investor]

Are men better at negotiating? This has not been the case in my experience!

Joking aside is there data on this? Seems like low hanging fruit if true.

Whether better or not I don't know, but they are more likely to actually do it. I think the data is pretty clear on that.

[Kamban]

Is there a pay gap difference in Ob/GYN, since that field is dominated by women, and many are in positions of leadership. Do the men get the same or less? Or do they get more even in that field

[Kamban]

Around here the hospitals offer the same salary to both men and women if it is a salaried position. If it is wRVU, it is the same to both sexes. So if there is a pay difference, it might mean that person is working longer, harder or doing more calls.

A strange thing happened here. One of the hospitals was criticized as having more male leadership positions and having a bit of old boys network.. A new CEO came in ( male) and made the Head of GI and Hem/Onc as females. The two selected were quite junior and had no leadership experience but hey, it helped our hospital system's image and that is what matters. And they got the corresponding pay raises. Sometimes things go the other way too.

[Tim]

In our medium-size surgical subspecialty group, our newest partner is the only female and she generates the most RVU and has the highest income. She also works harder/more than anyone in the group in my opinion. She took only one week off after delivering her child. I might feel like this is too little and not good from a societal standpoint, but from a personal standpoint she is a partner and we have an RVU based model. We hired her knowing that there are patients who prefer a female doctor and she is able to capture this population, and she is thriving on this. There are certain ethnicity in the community that we think would prefer to see a doctor of the same ethnicity, so our next hire will probably to try and capture this population.

I think this is an example where the support structure in an employed position can impact the typical wRVU statistics. You don’t add a PA, a second MA etc. until after the fact. I can guarantee this lady worked her tail off to generate the volume. If the group resources are available it works.
One data point that worked was graphically mapping the location of patients and the referral sources. The efforts are substantial as all of you know. Marketing takes time, but has a delayed impact and can be constrained. A female takes more crap to avoid being labeled. In this case, patients don’t just appear. I speculate uncompensated work greatly impacted the volume and the other partners benefited as well.
The mapping identified opportunities by adding 2 more to the “team”. Another PA and MA will support a jump in volumes.
I would suggest asking her how much and what efforts it took. My guess she might call the men “slackers” with a good natured wink. Building her brand paid off. Be careful with the assumption that it was just preferring a female is the point.

[medicoFIRE]

My wife (a physician) explained it to me like this. When men ask for more money or complain they are seen as ambitious or discerning. When women do it, they are seen as b*tchy. I think it gets to the fact that women’s motives and requests are perceived differently than men’s And this even occurs when women are the ones in charge. Of course this is wrong, but it seems to be the reality. The question is how do you fix that? Unfortunately that aspect of this issue does not seem amenable to a quick fix.

While I agree with most than the difference isn’t 28%, there is still a difference. But I think it’s at a societal level and not well controlled for in the short term. I think longterm we will see that presumably single digit gap get smaller and smaller as society evolves. Eventually I think we can reach parity when controlling for time worked, vacation, parental leave etc. While its good to draw attention to this very real issue, I think it does a disservice to women by claiming it is a 28% gap while massaging the data. There should be no shame in stating its a 9% gap for example because that would still be too much of a gap when controlled for all the variables. I especially don’t like when they give a very broad paygap which presumably includes all jobs in existence. Women tend to chose different jobs even in the most gender equal societies such as Sweden. I understand why they massage the data to say it’s 28% though. The headline lacks oomph when its only 9% and everything seems to have to be clickbait to get attention.

[Otolith]

If women in general: work just as hard (volume/efficiency/hours), are as competent or often more competent, and get payed less for the same work Why isn't everyone hiring women?

The men vs women "pay gap" is just a social buzz phrase that infuriates men and causes women to blame men.

The problem is our society unfortunately values maybe even expects women to do more work outside of the office. Things like childcare fall unequally to women and leave less available time ( and energy!) for women to put into the workplace.

Focus on the barriers keeping women from earning their max desired potential not the inherently flawed buzz phrase that there is a large discrepancy in reimbursement for the same work...

[White.Beard.Doc]

My daughter is a millennial working in tech. She refused to ask or negotiate for pay comparable to the men in similar positions. It drove me crazy, but she said she didn’t care.

This year she got recruited by another company with an offer for a position at double her prior compensation. As a result, her current company countered by doubling her salary and she is finally receiving pay comparable to the men in similar positions.

[VentAlarm]

I think one thing never discussed on the topic (partly because it would be nearly impossible to quantify and partly because it’s not PC), is what the spouse’s pay is. I’m a male and my wife is a stay at home mom. Stay at home wife’s are likely an order of magnitude more common than stay at home husbands. All of the women in my department who are married are married to people who are gainfully employed, some of whom are highly compensated subspecialist. Several of the men have stay at home wives. Only one male doc in my group has a wife who is a surgical subspecialist who makes more than him.

I think a better comparator to evaluate the severity of the gender pay gap would be to look at those in similar family situations. I suspect that my pay would likely be much closer to that of a female who is the sole bread winner for her family than that of either a female married to a high income earner or a male married to a high income earner. I suspect that those who have spouses with high incomes are less likely to take on the more unpleasant but highly compensated tasks and negotiate for higher pay regardless of gender. I know if my wife was making six figures, I’d be working fewer nights.

[Random1]

Thomas Sowell gives a great explanation for gender pay gaps, if has more to do with taking time off during child bearing years than anything else. Women who take time off during child bearing years and raising kids, out of the work force lose a competitive advantage at a crucial time in their career which they have difficultly getting back financially for the rest of their career. If you control taking time off during early part of careers women tend to earn equal if not more than men.

My wife is a nurse, she took 10 years off during raising our kids, when she went back to work , she made significantly less per hour than her other friends who worked for the last 10 years in nursing. It was not sexist , it was a function of not working. If I took 10 years off early in my career , my productivity seeing patients would be a lot less that it is, and probably my knowledge base, and would likely have a hard time competing with my peers. I would make less , not because of some external factor , I would make less because I was less productive because of my own doing.

As far as medicine an RVU is an RVU , it does not discriminate male/female/race or sexually orientation. I could not find any data on Medicare website stating that a wRVU is based upon any other metric other than work provided.

[StateOfMyHead]

My daughter is a millennial working in tech. She refused to ask or negotiate for pay comparable to the men in similar positions. It drove me crazy, but she said she didn’t care.

This year she got recruited by another company with an offer for a position at double her prior compensation. As a result, her current company countered by doubling her salary and she is finally receiving pay comparable to the men in similar positions.

This is unfortunate and not uncommon from what I have heard/seen with friends, colleagues of my generation who take what is offered. I was hoping the younger females were doing a better better job at requiring a fair and reasonable compensation package.