Gender and compensation among surgical specialties in the Veterans Health Administration

Maxwell, Jessica H.; Randall, James A; Dermody, Sarah M.; Hussaini, Adnan S.; Rao, Hamsini; Nathan, Ajay S.; Malekzadeh, Sonya; Litvack, Jamie R.

doi:10.1016/j.amjsurg.2020.02.045

Cited by 16 publications

(12 citation statements)

References 15 publications

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“…Predictors of a lower salary for health providers at the Veterans Health Administration remain dependent on gender, specialty, H-index, location, and years in practice. 26 It was beyond the scope of this study to review every code billed by every surgeon to identify granular points of difference, but our study shows that differences in billing add up over time. Other shortcomings include the fact that the dollar value of each code does not reflect actual reimbursement.…”

Section: Discussionmentioning

confidence: 89%

Surgeon Gender-Related Differences in Operative Coding in Plastic Surgery

Kalliainen

Chambers

Crozier

et al. 2022

Plastic &Amp; Reconstructive Surgery

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Background: Numerous studies in the medical and surgical literature have discussed the income gap between male and female physicians, but none has adequately accounted for the disparity. Methods: This study was performed to determine whether gender-related billing and coding differences may be related to the income gap. A 10 percent minimum difference was set a priori as statistically significant. A cohort of 1036 candidates’ 9-month case lists for the American Board of Plastic Surgery over a 5-year span (2014 to 2018) was evaluated for relationships between surgeon gender and work relative value units, coding information, major and minor cases performed, and work setting. Data were deidentified by the American Board of Plastic Surgery before evaluation. The authors hypothesized that work relative value units, average codes per case, major cases, and minor cases would be at least 10 percent higher for male than for female physicians. Results: Significant differences were found between male and female surgeons in work relative value units billed, work relative value units billed per case, and the numbers of major cases performed. The average total work relative value units for male surgeons was 19.34 percent higher than for female surgeons [3253.2 (95 percent CI, 3090.5 to 3425.8) versus 2624.1 (95 percent CI, 2435.2 to 2829.6)]. Male surgeons performed 14.28 percent more major cases than female surgeons [77.6 percent (95 percent CI, 72.7 to 82.7 percent) versus 90.5 percent (95 percent CI, 86.3 to 94.9 percent); p = 0.0002]. Conclusions: The authors’ findings support the hypothesis that billing and coding practices can, in part, account for income differences between male and female plastic surgeons. Potential explanations include practices focusing on larger and more complex operative cases and differences in coding practices.

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Section: Discussionmentioning

confidence: 89%

Surgeon Gender-Related Differences in Operative Coding in Plastic Surgery

Kalliainen

Chambers

Crozier

et al. 2022

Plastic &Amp; Reconstructive Surgery

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“…This further reflects the overrepresentation of women in lower paying surgical specialties such as Gynecology. The differences in pay were attributed to gender, seniority, surgical specialty, H-index (a measure of scholarly activity), and geographic location [26].…”

Section: Impact On Female Surgeonsmentioning

confidence: 99%

The surgical gender gap: the impact of surgeon gender in medicine and gynecologic surgery

Galhotra

Smith

Norton

et al. 2022

Current Opinion in Obstetrics &Amp; Gynecology

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Purpose of reviewThe purpose of this review is to summarize the current literature evaluating the effect of surgeon gender on patient outcomes and satisfaction, and the impact of gender bias on female surgeons. Recent findingsThe proportion of female physicians has increased in recent years, especially in Obstetrics and Gynecology. Recent literature assessing this impact supports equivalent or superior medical and surgical outcomes for women surgeons and physicians. It also reveals superior counseling and communication styles as perceived by patients. However, women in medicine receive lower patient ratings in competence, medical knowledge, and technical skills despite the existing evidence. Additionally, female physicians experience pay inequality, limited advancement opportunities, higher prevalence of microaggressions, and higher rates of burnout.

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“…The following available participants' demographic information were included in the analysis as control variables in the regression analysis: gender (female vs. male), professional rank (junior, middle, and senior), marital status (married vs. unmarried), educational level (bachelor's degree or below vs. master's or doctoral degree), work hours per week, years of practice, whether being at an administrative position (e.g., department chair or vice chair), and whether working in outpatient settings. These variables were included based on data availability and prior literature that indicated their associations with physician income (3,5,(8)(9)(10)14).…”

Section: Control Variablesmentioning

confidence: 99%

“…There are many factors contributing to income differences, such as age, marital status, educational level, specialty, work hours, and administrative position (3,5,(8)(9)(10). In China's healthcare system, professional rank, a recognition of the level of technical expertise and work ability for healthcare professionals, is also associated with physician income (6).…”

Section: Introductionmentioning

confidence: 99%

Gender differences in income among psychiatrists in China: Findings from a national survey

Han

Shen²,

Tong³

et al. 2022

Front. Public Health

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BackgroundGender income disparity in healthcare settings is a longstanding issue around the globe, but such evidence among Chinese psychiatrists is scarce. This study investigated whether gender income differences exist among physicians in China.MethodsData came from the 2019 national survey data of 4,520 psychiatrists in major public psychiatric hospitals across China. Self-reported monthly income after tax (in Chinese Yuan, CNY) by participants at all professional ranks was assessed. Average monthly income by gender was reported. Adjusted income differences between male and female psychiatrists were examined using multivariable regression models, adjusting with inverse probability of treatment weights and controlling for psychiatrist demographics (e.g., gender, professional rank, marital status, educational level, and work hours) and hospital fixed effects.ResultsThe unadjusted mean difference in monthly income after tax by gender was 555 CNY (about $86; 95% CI, −825 to −284; mean [SD] for men: 8,652 [4,783] CNY and for women: 8,097 [4,350] CNY) in all psychiatrists. After regression adjustments, the income difference by gender among all psychiatrists reduced substantially and became insignificant. However, gender income difference was still observed among senior-level psychiatrists, where female psychiatrists earned 453 CNY (about $70; 95% CI, −810 to −95) significantly less than male psychiatrists.ConclusionChina achieved gender equity in income for psychiatrists overall, the observed income differences among senior level psychiatrists, however, reveal the persistence of gender inequity at the highest level of professional hierarchy. These findings call for policy attention to the issue of gender income disparity among psychiatrists in China's healthcare system.

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Gender and compensation among surgical specialties in the Veterans Health Administration

Cited by 16 publications

References 15 publications

Surgeon Gender-Related Differences in Operative Coding in Plastic Surgery

Surgeon Gender-Related Differences in Operative Coding in Plastic Surgery

The surgical gender gap: the impact of surgeon gender in medicine and gynecologic surgery

Gender differences in income among psychiatrists in China: Findings from a national survey

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