Changing gender gap and practice patterns in reproductive endocrinology and infertility subspecialists in the United States: a Society for Reproductive Endocrinology and Infertility report.

OBJECTIVE: To identify changes in current practice patterns, salaries, and satisfaction by gender and by years in practice among board-certified reproductive endocrinology and infertility (REI) subspecialists in the United States. DESIGN: Cross-sectional web-based survey including 37 questions conducted by the Society for Reproductive Endocrinology and Infertility. SETTING: Not applicable. PATIENT(S): None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The primary outcome measures were total compensation and practice patterns compared by gender and the type of practice. The secondary outcomes included demographics, the number of in vitro fertilization cycles, surgeries performed, and the morale of survey respondents. RESULT(S): There were 370 respondents (48.4% women and 51.4% men). Compared with a similar survey conducted 6 years earlier, a 27% increase in the number of female respondents was observed in this survey. There was a marginally significant trend toward lower compensation for female than male REI subspecialists (17% lower, $472,807 vs. $571,969). The gap was seen for responders with ≥10 years' experience, which is also when there was the largest gap between private and academic practice (mean $820,997 vs, $391,600). Most (77%) felt positively about the current state of the reproductive endocrinology field, and >90% would choose the subspecialty again. CONCLUSION(S): There has been a substantial increase in the number of recent female REI subspecialists showing less disparity in compensation, and the gap appears to be closing. There is an increasing gap in compensation between private and academic practices with ≥5 years of experience. Reproductive endocrinology and infertility remains a high morale specialty.

Razão e razões masculinas: geração de desigualdades pelas práticas de meritocracia em uma empresa tecnocrática brasileira / Rationality and male reasons: generation of inequalities through meritocracy practices in a Brazilian technocratic company

O artigo revela como a meritocracia ­ transvestida como um sistema neutro de promoções ­ produz e reproduz as desigualdades entre atributos de gênero, em uma empresa brasileira do setor elétrico. O enfoque teórico estabelece paralelo entre a prática meritocrática, como luta de categorias e seus valores, e a praxiologia de Bourdieu. A abordagem é qualitativa, baseada em entrevistas semiestruturadas e observação participante. Da análise de conteúdo emergiram três pares de categorias analíticas: técnico/não técnico, meritoso/não meritoso e masculino/feminino. A associação entre atributos masculinos e méritos mais valorizados é uma relação desigual de gênero não explícita no discurso, mas envolta em atributos de mérito que se agrupam em rótulos neutros e dissimuladores associados à masculinidade. O estudo contribui com a ampliação da compreensão sobre a construção de significados que subjazem aos processos de ascensão na estrutura hierárquica organizacional, ao revelar as relações entre os atributos de méritos e de valor; além de os atributos de masculinidade e racionalidade

The paper reveals how meritocracy ­ disguised as a neutral promotion system ­ produces and reproduces inequalities between gender attributes in a Brazilian company in the electricity sector. Our theoretical approach establishes a parallel between meritocratic practice as a struggle between categories and their values and Bourdieu's praxeology. Our approach is qualitative and based on semi-structured interviews and participant observation. From content analysis, three pairs of analytical categories emerged: technical/non-technical; meritorious/not meritorious; and male/female. The association between more valued male and merit attributes is an unequal gender relation which discourse maintains implicit but wrapped in merit attributes which are grouped in neutral and dissimulating labels associated with masculinity. This study broadens the understanding of the construction of meanings underlining the ascension processes in this organizational hierarchical structure by showing the relations between the attributes of merit and value, and those of masculinity and rationality

Reimbursement for Female-Specific Compared With Male-Specific Procedures Over Time.

OBJECTIVE: To evaluate whether per-procedure work relative value units (RVUs) have changed over time and to compare time-based compensation for female-specific procedures compared with male-specific procedures. METHODS: Using the National Surgical Quality Improvement Program files for 2015-2018, we compared operative time and RVUs for 12 pairs of sex-specific procedures. Procedures were matched to be anatomically and technically similar. Procedure-assigned RVUs in 2015 were compared with 1997. Procedure compensation was determined using median dollars per RVU provided in SullivanCotter's 2018 Physician Compensation and Productivity Survey. This was compared with specialty-specific McGraw-Hill per-RVU data from 1994. Statistical analysis was performed with chi-square and Kruskal-Wallis tests. RESULTS: A total of 12,120 patients underwent 6,217 male-specific procedures and 5,903 female-specific procedures. Male-specific procedures had a median (interquartile range) RVU of 25.2 (21.4-25.2), compared with 7.5 (7.5-23.4) for female-specific procedures (P<.001). Male-specific procedures were 79 minutes longer (median [interquartile range] 136 minutes [98-186] vs 57 minutes [25-125], P<.001). Female-specific procedures were reimbursed at a higher hourly rate (10.6 RVU/hour [7.2-16.2] vs 9.7 RVU/hour [7.4-12.8], P<.001). However, male-specific procedures were better reimbursed ($599/h [$457-790] vs $555/h [$377-843], P<.001). Overall, per-procedure RVUs for male-specific surgeries have increased 13%, whereas, for female-specific surgeries, per-procedure RVUs have increased 26%. Reimbursement per RVU for male-specific procedures has decreased 8% ($67.30 to $61.65), whereas for female-specific procedures it has increased 14% ($44.50 to $52.02). CONCLUSION: Increases in RVUs and specialty-specific compensation have resulted in more equitable reimbursement for female-specific procedures. However, even with these changes, there is a lower relative value of work, driven by specialty-specific compensation rates, for procedures performed for women-only compared with equivalent men-only procedures.