“The Hoff paper is a goldmine,” says Linda Brodsky, MD, a pediatric otolaryngologist in Buffalo, N.Y., who co-chairs AMWA’s Gender Equity Task Force and whose organization, Expediting the Inevitable, advocates for gender equity in healthcare. “How is it that when you have shift work, women are getting paid less per shift? Because Hoff tells you at the end, employers can get away with it. Even if they know they are underpaying women, they will take the chance because it’s so hard for anybody to take legal action.”
Women also find themselves in a double bind when it comes to negotiating higher compensation, says Barbara Gault, PhD, executive director of the Institute for Women’s Policy Research in Washington, D.C. Some suggest a pay gap exists because women are not negotiating for themselves, but research shows women tend to be perceived as less likable when they are more assertive about higher wages, she says.
Erin Stucky Fisher, MD, MHM, has seen this phenomena play out in her roles as medical director for quality at Rady Children’s Hospital in San Diego and associate program director for the University of California at San Diego Pediatric Residency Program.
“I do a lot of interviewing for the hospital, and it does seem, in general, that women are less likely to promote themselves than men in the same situation,” says Dr. Fisher, an SHM board member who is also assisting with the HM12 “Women in Hospital Medicine” session. “There are reasons behind it that might have to do with women not wanting to be perceived as self-serving or arrogant.”
I do a lot of interviewing for the hospital, and it does seem, in general, that women are less likely to promote themselves than men in the same situation. There are reasons behind it that might have to do with women not wanting to be perceived as self-serving or arrogant
—Erin Stucky Fisher, MD, FAAP, MHM, medical director for quality, Rady Children’s Hospital, associate program director, University of California at San Diego Pediatric Residency Program, SHM board member
Dr. Brodsky agrees with the perception issues facing physicians.
“Women are supposed to be grateful, accommodating, and get along, which are excellent qualities,” she says. “But when you’re expected to do that and you instead negotiate with any kind of spirit, it’s perceived as troublemaking, whereas in men, it’s perceived as strength.”
Subtle forms of gender discrimination continue to exist in workplaces, Dr. Gatta says. Beliefs remain that men have a family to support, so they should be paid more, and that women are in the workforce just for extra money, even though recent data show that women’s income is key to families’ well-being, she notes.
Common patterns of gender bias will be discussed at the HM12 session, says Dr. Reich, who was a victim of gender pay disparity when she worked a locum tenens job earlier in her career.
“There was no logical explanation. The men did less work by all measures, and the other woman and I didn’t have young children at home, so explanations of women trading in money for time with family didn’t apply,” she explains. “Why did they think I should be paid less? I didn’t understand, and I never got a logical reason.”
Potential Solutions
Shortly after arriving at Wake Forest in 2004, Dr. Reich had the opportunity to build the hospitalist program. A set of thorough, transparent criteria for determining compensation were established almost immediately to help prevent pay discrepancies.
“We tried to be as objective as we could, and we involved the group in talking about it because we felt it was important,” she says.