Disparities in Physician Compensation—A Call to Action

Abstract

Historically, a gender wage gap has existed across every field in the US. The US Bureau of Labor Statistics estimated in 2020 that full-time working women had median salaries that were 82% of those of men. 1 This disparity persisted across all age groups and ethnicities. In medicine, Jena et al 2 showed in 2016 that academic male physicians out earned female physicians by a mean difference of $51 315 annually. 2 Thus, the findings of gender inequity in medical industry compensation presented by Sullivan et al 3 are not surprising. But the degree to which mean payments to top earners differed ($41 320 for women vs $1 226 377 for men) 3 is still astonishing.There was no obvious identifiable explanation for this disparity. The authors 3 found that men were paid more at every academic stage, including the assistant, associate, and fulltime professor levels. Men were paid more even after adjusting for adjusting for h-index, a measure of research impact and accomplishment. Men were even paid more in the femaledominated specialties of obstetrics and gynecology and pediatrics. 3 This is, quite simply, unfair.These disparities not only represent financial inequity, but also lost opportunities. Surveys have shown that women in surgical residency have similar leadership aspirations as men and similar goals of becoming experts in their field. 4 But the field of medicine, both clinical and in industry, as a whole has done a poor job at promoting and sponsoring women into leadership roles. As a profession, we must do better. Greater efforts should be made at increasing the visibility of women at academic societies, including leadership roles, committee appointments, and moderators and discussants at the podium. 5 Medical companies need to reevaluate their practices, too, in terms of how they diversify their leadership-all but 1 company in the study had male CEOs, and board members were predominantly male. There also needs to be greater transparency in how companies recruit and compensate medical consultants.This study by Sullivan et al 3 represents a call to action and an opportunity. Women are increasing in numbers in every specialty. Their opinions and perspectives must be valued and reflected in the development of medical devices and drugs. Increasing recruitment of women into leadership positions in both industry and medicine will certainly help, as will increased transparency in consulting practices, consultant opportunities, and structure of compensation fees. Above all, we must remember that physicians and surgeons as a group hold considerable influence, as the end users of medical devices, products, and drugs that the industry develops. As the number of women entering medicine and surgery continues to rise, this growth should be leveraged. Holding leaders in surgery and industry accountable will hopefully lead to meaningful results. We look forward to the change.

Gender Disparities in Medical Industry Payments

“…To the Editor We commend Sullivan et al for their important study highlighting gender inequity in medical industry payments to US-based physicians. The article and accompanying Invited Commentary appropriately discuss the financial implications for female physicians, the lost opportunities for personal academic advancement, and the lack of defensible justification for the discrepancies uncovered. However, we believe that another implication is worth highlighting: the potential impact on the next generation of female physicians.…”