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Is Medicine Still a Man’s World?

Written by: Rachelle Vanderzanden

Financial services is an industry dominated by men.  Less than one in four advisors are women, and there is a 35% pay gap for financial managers.  Yet I entered this field, because I saw an opportunity to take control of my career.  In financial advising, I may be limited by the number of hours that I am able to work with a young family (something a lot of women experience), but I have no ceiling and I control my career and more importantly, my business.  I work with clients on my terms and get to focus on helping those clients in whatever ways that I can.  More and more, I am coming to realize that with my female clients, part of what I can do is be open and honest about how our gender affects our finances.

Gender Inequality in Medicine

At Finity Group, many of our clients are physicians and the medical professions are no stranger to gender inequity.  So let me ask you all one question:  Do you think your gender affects how much you’re paid?  We all know that a gender pay gap exists (or at least I hope we do).   For many men, I think they might answer that question, “No.”  And for many women, the answer is, “Of course it does.”

Did you know that for physicians, it is worse than for many other professions (71 cents on the dollar to be exact)?  The craziest part is that it’s not getting any better.  Last year a colleague forwarded a CNN article to me that was my first introduction to the pay divide in medicine, and recently Time Magazine published another article on the same topic.   The gender pay gap for physicians is about 30 percent, and both articles found that in 2018 and 2019, this pay gap got bigger rather than smaller.  Women may be half of the medical school graduates in the United States now, but when compensation is not equal, medicine still feels like a man’s world.  How do we go beyond being frustrated and angry and attempt to fix it?

How Do We Fix It?

Short answer:  I have no idea.

Long answer:  We still have to try!

In training, residents and fellows are all paid by a very structured and transparent compensation package.  Some GME departments even publish this information online.  The problem starts when you go out and get that first “big kid” job.  Compensation is generally very secretive, and every contract is negotiated on an individual basis (academic institutions being much more structured than private practices).  I cannot stress enough how important it is to negotiate those first contracts.  You are setting the tone for how you expect to be compensated throughout your career.  If you are not sure what to ask for or how to ask for it, enlist the help of a financial advisor or contract review attorney.

gender inequality in medicine

Beyond the initial contract negotiation, renegotiate whenever you can.  I’ve had male colleagues ask for larger raises at review time or when a contract was up.  Why did I not do that myself?  If you find that you spend more time on necessary administrative tasks than your male colleagues and they see more patients resulting in more RVUs, maybe you make less production-based compensation and can argue for a larger fixed base pay or bonuses.  Think of all the ways that you provide value and talk about it.

Let’s not violate any non-disclosure agreements here, but we should all talk more openly about what and how we are paid.  Gender is not the only thing that can affect our pay.  Race plays a huge part as well, whether we admit it or not, so let’s put it all out there.  Not just in anonymous surveys, but in our places of work.  Talk about this with prospective employers.  If they have an open book policy regarding compensation, then it becomes much more problematic for them if they are unfairly discriminating.   Honestly, I don’t think most employers intentionally pay women (or persons of color) less than white men.  Whether it is intentional or not, most of them do, or there wouldn’t be such huge discrepancies.  If we force employers to look this problem in the eye, maybe they will do more about it.

Last but not least, educate yourself.  Knowledge is power.  Find salary data specific to your specialty and your region.  Read.  When you feel more confident with your finances in general, talking about your salary and compensation will come more naturally.  Don’t let money be something that you put on the back burner and assume it will take care of itself.  Honestly, you’ll probably do okay, but just okay is not what we are aiming for here.   We want equitable compensation and acknowledgement that our work provides just as much value as a man’s.

The Power of Advice

In an effort to put your best foot forward, have a team on your side: an accountant, an attorney, and a financial planner.  Talk openly with these professionals about your current compensation and your goals.   Experienced contract review attorneys can give you a good sense of how your contract looks in comparison to others.   Accountants, financial advisors, and tax professionals are very well acquainted with the income of clients.   Obviously, they can’t tell you the details of others’ finances, but they might be able to tell you if they think you’re underpaid.  If you don’t ask, they will not tell you.  Have a financial advisor on your side to talk openly about your compensation, help prioritize what you do with that income, and help achieve your long-term goals.   Ultimately, what you do with your money might matter more than how much you make.  But we all want to be treated fairly, so who’s with me?

average doctor salary