Equal pay for equal work: Disparities in compensation in vascular surgery.

Physician compensation varies by specialty, gender, race, years in practice, type of practice, location, and individual productivity. We reviewed the disparities in compensation regarding the variation between medical and surgical specialties, between academic and private practice, between gender, race, and rank, and by practice location. The physician personal debt perspective was also considered to quantify the effect of disparities in compensation. Strategies toward eliminating the pay gap include salary transparency, pay equity audit, paid parental leave, mentoring, sponsorship, leadership, and promotion pathways. Pay parity is important because paying women less than men contributes to the gender pay gap, lowers pension contributions, and results in higher relative poverty in retirement. Pay parity will also affect motivation and relationships at work, ultimately contributing to a diverse workforce and business success. Rewarding all employees fairly is the right thing to do. As surgeons and leaders in medicine, establishing pay equity is a matter of ethical principle and integrity to further elevate our profession.

Gender Differences in Compensation in Anesthesiology in the United States: Results of a National Survey of Anesthesiologists.

BACKGROUND: A gender-based compensation gap among physicians is well documented. Even after adjusting for age, experience, work hours, productivity, and academic rank, the gender gap remained and widened over the course of a physician's career. This study aimed to examine if a significant gender pay gap still existed for anesthesiologists in the United States. METHODS: In 2018, we surveyed 28,812 physician members of the American Society of Anesthesiologists to assess the association of compensation with gender and to identify possible causes of wage disparities. Gender was the primary variable examined in the model, and compensation by gender was the primary outcome. Compensation was defined as the amount reported as direct compensation on a W-2, 1099, or K-1, plus all voluntary salary reductions (eg, 401[k], health insurance). The survey directed respondents to include salary, bonuses, incentive payments, research stipends, honoraria, and distribution of profits to employees. Respondents had the option of providing a point estimate of their compensation or selecting a range in $50,000 increments. Potential confounding variables that could affect compensation were identified based on a scoping literature review and the consensus expertise of the authors. We fitted a generalized ordinal logistic regression with 7 ranges of compensation. For the sensitivity analyses, we used linear regressions of log-transformed compensation based on respondent point estimates and imputed values. RESULTS: The final analytic sample consisted of 2081 observations (response rate, 7.2%). This sample represented a higher percentage of women and younger physicians compared to the demographic makeup of anesthesiologists in the United States. The adjusted odds ratio associated with gender equal to woman was an estimated 0.44 (95% confidence interval, 0.37-0.53), indicating that for a given compensation range, women had a 56% lower odds than men of being in a higher compensation range. Sensitivity analyses found the relative percentage difference in compensation for women compared to men ranged from -8.3 to -8.9. In the sensitivity analysis based on the subset of respondents (n = 1036) who provided a point estimate of compensation, the relative percentage difference (-8.3%; 95% confidence interval, -4.7 to -11.7) reflected a $32,617 lower compensation for women than men, holding other covariates at their means. CONCLUSIONS: Compensation for anesthesiologists showed a significant pay gap that was associated with gender even after adjusting for potential confounding factors, including age, hours worked, geographic practice region, practice type, position, and job selection criteria.

Optometry Compensation Study: Narrowing Down the Unexplained Gender Wage Gap in Optometry.

SIGNIFICANCE: Men earn at least 6.5% more than women in their first full-time jobs as optometrists. For current salaries, the gender wage gap is more than 13%. This study details the gender wage gap that remains after controlling for practice ownership, residency training, and employer-defined full-time work. PURPOSE: The purpose of this study was to measure the gender wage gap by region and practice type for full-time optometrists who did not complete a residency and do not own their practice. METHODS: Participants completed an online survey, providing data for their first and current optometry positions and demographic information. Respondents who reported full-time employment in the United States, not completing a residency, and not owning their practice were selected for further analysis by census region and practice type. In each category, the gender wage gap was calculated. RESULTS: In all regions and practice types, men were paid higher starting salaries than women. For current salaries, men were paid higher in almost all regions and practice types. The wage gap increased from starting salary to current salary, although not in all regions and practice types. CONCLUSIONS: When practice ownership, residency completion, and full-time work are controlled for, there remains a difference in the pay received by men and women in optometry. The salary data presented in this study may help optometrists narrow the wage gap.

Salary Disparities in Academic Urogynecology: Despite Increased Transparency, Men Still Earn More Than Women.

OBJECTIVE: To understand the compensation differences between male and female academic urogynecologists at public institutions. METHODS: Urogynecologists at public universities with publicly available salary data as of June 2019 were eligible for the study. We collected characteristics, including sex, additional advanced degrees, years of training, board certification, leadership roles, number of authored scientific publications, and total National Institutes of Health funding projects and number of registered clinical trials for which the physician was a principal or co-investigator. We also collected total number of Medicare beneficiaries treated and total Medicare reimbursement as reported by the Centers for Medicare & Medicaid Services. We used linear regression to adjust for potential confounders. RESULTS: We identified 85 academic urogynecologists at 29 public state academic institutions with available salary data eligible for inclusion in the study. Males were more likely to be an associate or a full professor (81%) compared with females (55%) and were more likely to serve as department chair, vice chair, or division director (59%) compared with females (30%). The mean annual salary was significantly higher among males ($323,227 ± $97,338) than females ($268,990 ± $72,311, P = 0.004). After adjusting for academic rank and leadership roles and years since residency, the discrepancy persisted, with females compensated on average $37,955 less annually. CONCLUSIONS: Salaries are higher for male urogynecologists than female urogynecologists, even when accounting for variables such as academic rank and leadership roles. Physician compensation is complex; the differences observed may be due to variables that are not captured in this study. Nevertheless, the magnitude of disparity found in our study warrants further critical assessment of potential biases within the field.

Reexamining the persisting wage gap between male and female PAs.

OBJECTIVE: To determine the magnitude of any difference in total compensation between male and female physician assistants (PAs) after controlling for personal and workplace factors related to compensation. METHODS: Using data from the 2019 AAPA Salary Survey, the authors conducted a sequential regression analysis to examine the relationship between a variety of personal and practice demographics and total compensation. RESULTS: After controlling for compensation-related factors, a wage gap between male and female PAs persisted: female PAs were paid almost $0.93 for every $1 male PAs were paid in the first year of work ($9,010 less). This wage gap widened by $201 for every year of work experience. CONCLUSIONS: A wage gap between male and female PAs persists even after including all compensation types and controlling for compensation-related factors that may differ between male and female PAs. Proposed policy implications could begin to mitigate the gap.

Gender Wage Disparities in Medicine: Time to Close the Gap.

Women physicians are paid less than their male peers across medical specialties and geographies. While the medical literature to date has focused on documenting the existence of a wage gap, less attention has been paid to fixing this gap. We focus on interventions around auditing, salary transparency, family leave, and childcare that can be implemented to advance gender wage parity.

Faculty Equity, Diversity, Culture and Climate Change in Academic Medicine: A Longitudinal Study.

There is a national call for academic medicine to use evidence-based initiatives to improve its culture and climate. The authors report data-driven policy and programmatic interventions that were associated with increased faculty diversity, equity, respectful behavior and improved faculty climate, at UC San Diego Health Sciences. METHODS: Based on demographic and survey data, interventions were designed to improve the climate between 2005 and 2015. Interventions included routine measuring and dissemination of demographic data, changes and dissemination of policy and procedures, and new and improved faculty development programming. Impact was measured using demographic data over time, salary equity studies, and school-wide climate surveys in 2005, 2011, and 2015. Specific outcomes included measures of diversity, salary equity, behavior, and climate. RESULTS: Over the ten-year period, the proportion of women increased from 16% to 23% of tenure/tenure-track faculty and 31%-40% of all faculty. Underrepresented minority faculty increased from less than 1%-7% of tenure/tenure-track faculty and from 5% to 8% of all faculty. While women continued to be paid less than men, the adjusted difference dropped from 23% to 12%. Reports of inappropriate behavior by faculty decreased significantly, while satisfaction and knowledge about institutional mentoring and resources improved. CONCLUSION: Multiple interventions including new faculty development programs, changes in policy, and measuring demographics/climate supported diverse faculty recruitment, enhanced a culture of respect and improved faculty morale. Cultural changes in policy, periodic faculty data collection with dissemination, and increased faculty development, improve the climate in academic medicine.

A care ethics approach to the Gender Kidney Donation Gap.

Many studies have shown that women are more likely than men to be living kidney donors, and the discrepancy is particularly marked in heterosexual couples: wives are more likely than husbands to donate a kidney to their spouse. This 'Gender Kidney Donation Gap' can be understood in terms of Carol Gilligan's claims about gender differences in ethical decision-making style, making it appropriate to analyse responses to this imbalance using an ethic of care. This article centres the vast majority of living donors, those who donate in the context of a significant pre-existing relationship. A cost-neutral approach is unfair on donors who make society richer and healthier by helping a loved one. However, models of kidney sale fail to offer an acceptable alternative, either (a) compelling donors to sell into a pool where they do not know the recipient or (b) allowing affluent individuals unfair access to kidneys. Drawing on surrogacy law in England and Wales, a model of compensation is proposed that includes a range of non-financial benefits. This option celebrates donation and expresses gratitude to all donors while avoiding the pitfalls of the marketplace, with an emphasis on fair treatment of donors. Nevertheless, if more generous treatment led to a 10% increase in directed donation, then it would be equivalent to doubling 'altruistic' stranger donations. As long as the Gender Kidney Donation Gap persists, the best response is to minimise the discomfort and disruption caused to donors by their profound act of kindness.

Female PAs-Where are we today?

As the physician assistant (PA) profession celebrates its 50th birthday, we can be proud of the gains our profession has accomplished. However, despite the positive reports of job satisfaction, a marked increase in female PA leaders, and overall gains in PA compensation, a significant wage gap remains between male and female PAs. The PA profession is flourishing but it is time female PAs are paid equitably.

[Sex/Gender-Responsive Health Research: New Funding Guidelines of the USA National Institutes of Health Can Bring a New Impetus to Germany]. / Geschlechtergerechte Gesundheitsforschung - Aktuelle Vorgaben der National Institutes of Health in den USA können neuen Schwung auch nach Deutschland bringen - Diskussionsbeitrag.

In June 2015, the National Institutes of Health (NIH) of the USA published a new funding guideline entitled "Consideration of Sex as a Biological Variable in NIH-funded Research". This guideline is part of the NIH policy to enhance quality and generalizability of health research. Its core element is the classification of sex as a key element of rigorous study designs. The requirement is that sex be defined as a biological variable, and taking the potentially relevant sex/gender related anatomical and physiological characteristics into account. In Germany, the "Guidelines and recommendations to assure good epidemiological practice" (GEP) of 1998 specify that the study design and research methods are to be designed so that sex/gender-specific aspects of the research question can be adequately detected. Mostly health research is restricted to the categorization of the study population into men and women and to the consideration of the sex/gender variable (man*woman) in the analyses. Research in accordance with the NIH guideline as well as with the German GEP needs to investigate differences and similarities between men and women, and also to look for factors that explain in what way being a man or a woman poses a risk or is protective against the development of diseases. This scientific basis is essential for the development and implementation of sex/gender equitable prevention, health promotion and health care, which in turn enables statutory health insurances to take sex/gender differences into account regarding the medical services they provide. The latter is a consequence of the current legal position in Germany, which is based on the Prevention law that was passed in 2015. In addition to the categorical sex/gender variable (man*woman), there is therefore the need to analytically differentiate between the dimensions sex (the biological factors) and gender (the socio-cultural ascriptions) as well as their interaction. For conceptual clarity, this paper proposes that the terms sex and/or gender be used only where the biological and/or socio-cultural aspects of being a man or a woman are explicitly taken into account. For the common sex/gender variable man*woman (based on self-reports, register data etc.) the term Survey sex (German: Erhebungsgeschlecht) can be used. Further, the establishment of a Federal Institute "Geschlecht und Gesundheit - Sex/Gender and Health" is recommended.

Exploring Explanations for the Female-Male Earnings Difference Among Registered Nurses in the United States.

Research has shown male registered nurses (RNs) outearn their female colleagues by approximately $5,000 annually. The aim of this study was to explore differences in characteristics of female and male fulltime employed RNs, and to examine whether these differences help account for the female-male earnings gap in nursing. Specifically, the researchers tested whether the gender earnings gap could be explained by differences in career aspiration, workplace experience, time taken out of the labor force for child-rearing, and physical strength. While some evidence suggested motivational differences in career aspirations between female and male RNs exist, evidence supporting other hypotheses was not found. Given the expansion of nurses' roles in health care delivery, serious deliberations of how to respond to the earnings gap in nursing is warranted.