Anju Patel, MD, a consultant for Mytonomy, a technology-based patient education company in Bethesda, Md., and former faculty at the Harvard Medical School Department of Otolaryngology–Head and Neck Surgery in Boston, said gender bias, harassment, and discrimination are significant in the field and may contribute to the wage gap. In fact, a 2020 survey of women in otolaryngology revealed that nearly half experienced some form of harassment at work (Laryngoscope. 2021;131:E380– E387). One in three harassment experiences were from physician colleagues or department leadership.
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April 2023Other research has shown a link between harassment and the gender pay gap (Gend Soc. 2017;31:333–358). “Harassment is tied to decreased productivity, leaving an untenable workplace and subsequent drop-out from the field,” Dr. Patel said. “This leads to setbacks in compensation. Furthermore, occupational segregation or underrepresentation of women in our field hurts the specialty.” The U.S. Department of Labor has targeted occupational segregation as a significant source of the gender wage gap that must be remedied.
The gender pay gap may be even wider in certain subspecialties. “You would think that in pediatric otolaryngology, where many women practice, the pay would be equitable,” Dr. Chandrasekhar said, “but that is not the case.”
Little Progress Made
The wage gap hasn’t changed much since Jennifer R. Grandis, MD, a distinguished professor of otolaryngology–head and neck surgery at the University of California, San Francisco, and her colleagues conducted a study on compensation differences between genders (Arch Otolaryngol Head Neck Surg. 2004;130:695–702). At that time, she found that female otolaryngologists earned approximately 20% less than men for performing the same work.
“Although salaries are usually determined locally, our field hasn’t taken any steps to put systemic measures in place to mitigate inequities,” Dr. Grandis said. “We haven’t made it a priority. If we would take this issue seriously, we would have hard conversations every time decisions about compensation came up, and we don’t.”
Unlike many academic centers, which continue to keep pay and other benefits as opaque as possible, Dr. Chandrasekhar said her private practice keeps income information transparent. All 250 physicians can see what other doctors in the practice make, how many procedures they do, how many patients they see, and so forth. This information can be used within one’s subspecialty for benchmarking purposes.
Dr. Chandrasekhar maintains that poorly run or gender-biased private practices shunt pay, procedures, and consults toward men and away from women, however, ensuring that the leaders’ pre-conceived ideas that women earn less are borne out. “This is insidious and self-propagating,” she said.