Women Physicians and Equal Pay Day—Getting Ready for Tomorrow

The practice of medicine is inherently stressful and becoming more so every day.  Long hours, ethical dilemmas, pressing problems, increasing regulations, and the conflicting demands of the individual patient vs. the healthcare system are but a few of the “extra stressors” that sit on top of the physician’s already challenging job of diagnosing and treating patients and, for children, their families.

The environment in what is sometimes called the “house of medicine” has been deemed toxic to women.   Women are treated differently as patients, in research, and as physicians by their still mostly male colleagues, usually their “superiors”.  This “house” of medicine is very large and has many rooms.  Let’s just focus on the room where medical education occurs for today.

Women now make up 51% of medical students and soon will comprise 50% of the physicians available to lead in medical education, to research new medical breakthroughs and to care for patients in the increasingly complex medical milieu in which we live.  Do we want this group of people to experience further stress, devaluation in the form of lower salaries, slower advancement of their work, less support, less cooperation, exclusion, isolation, and lack of recognition for their work and status?  I don’t. Not if they are going to care for you and me and be the medical leaders of tomorrow.  We want that pool of individuals to reach their full potential. 

So institutionalized gender discrimination puts our increasing population of female physicians at a distinct disadvantage.  It is insidious and often times takes years to recognize.  But it exists.  Is the day of reckoning is upon us?  Maybe.

But what can be done?  Wait for a generation or two to pass and hope that the rigid, male-dominated hierarchical house of medicine will no longer be perpetuated?  That thought is ludicrous, and we cannot wait another 50 years.  The number of women in the academies is no longer a problem.  It is the academy, i.e. the medical schools, where the problems begin and where they must first end.

Women faculty, who are the first contacts for the future doctors of America, must receive fair treatment.  The women faculty physicians who struggle in the academic workplace and the men who control these halls of academe imprint a negative message on the students of both genders.  Active intervention to expose these inequities requires transparency in hiring, compensation, and promotions as well as an evaluation of the overall culture.  These issues are readily quantifiable in medical schools and residency training programs—the one common experience for all physicians.   Federal funding and accreditation should be linked to those institutions that prove they are a gender neutral environment.  When there are severe penalties for maintaining the status quo, the status quo will change.

Maybe we should take the newly announced British approach and have mandatory salary audits for medical schools and training programs so as to proactively seek out gender pay inequities.  The concept is not new, but it is bold.  (Here’s another link to the British take on the issue.)

The healthcare system is receiving a lot of scrutiny these days even despite the fact that it is the one sector of the economy that is continuing to provide more jobs, and arguably greater value than any other industry.  Treatment of the female healthcare workers in this sector, especially the female physician whose supply and performance is critical to achieving the best health outcomes possible, is another reason to participate tomorrow on Equal Pay Day.