She fought the physician gender pay gap and won

Most of us likely remember our very first “grown up” paycheck as attending physicians. I know I do, even 16 years later.

After many years of working many hours but not making much money, that day finally came for me. My husband opened the envelope. (Back then your first paycheck arrived via snail mail, and you had to physically take it to the bank). I heard a laugh and something like, ”We’re in the money! Let’s celebrate!”

This led us to the local ABC store where we decided to buy, for the first time in our lives, top-shelf liquor. We purchased a triple-digit amount of very fine liquors that we then stored for the sole purpose of having a drink each payday, which became “Top-shelf Thursdays.”

We, as family physicians, do make great money. We need to remember this when speaking with our student learners. During our education and training, though, this is not the case. So when the change occurs, it is life-altering.

With the new income, things became a bit easier. I enjoyed my salary and my first physician job. Life was great. I had an 8-month-old child, and we were looking for a house on the water. My rookie lack of confidence began, slowly, to turn into something resembling confidence. I learned all about my patients and enjoyed working with my colleagues. I was coasting.

Discovering the gender pay gap in medicine

About two years into my career, I was still loving my job and life. I was a small-town doc living a small-town life. I had several colleagues who were also friends, and I continued my leadership relationships with others. During the course of several different conversations, I was shocked to learn that a less experienced male colleague was making significantly more in compensation. His initial offer, right out of residency, was substantially higher than what I was making after two years with the same organization.

Now, was this the fault of the new hire? Absolutely not. But it caught my attention. I reached out to friends and colleagues, and reviewed national trends in family medicine compensation. I was saddened to learn that my organization fit a pattern of gender-pay inequity.

I did not call it that at that time. I called it, “It’s not fair. I am being paid less for doing the same work with more years of experience because I have a vagina.”

I found examples of women in my field, in various career stages, being paid differently than their male counterparts. Sometimes this occurred in the same clinic. It was infuriating as well as eye opening.

So, what did I do?

Well, nothing. At first.

Speaking up against physician pay inequity

Then I learned my organization was considering restructuring compensation plans. I reached out to the regional financial administrator and requested a meeting. In full disclosure, the meeting was not just about gender-pay inequities. Some of it was about low compensation in general. I wanted to address both.

I was angry because it does not feel good to be undervalued. I provided all the data I could about how male physicians are compensated at a higher pay than women in the same role, regardless of specialty. I used all my past leadership experience to urge them to consider us all in the same pay bucket. I had no issue with using years of experience when considering salary. I had issues with using gender as a basis.

This was a low-level meeting, but I requested that my concerns be moved forward. The response was lukewarm, at best, but also not dismissed.

Was I intimidated during this time? Yes and no. I was still a a relative newbie and felt “imposter syndrome” long before I even knew what that term meant. But I also knew I had facts, experience and amazing colleagues who would support me.

Advocating for fair and equitable physician compensation

After this meeting I was asked to serve on work groups and committees, including a compensation plan workgroup. I was invited to attend organization leadership development classes. I was asked to sit at a giant administrative table as the guest who they probably didn’t want to invite but knew they should. I developed improved working relationships with colleagues and strengthened my reputation within the organization, which made my input and suggestions more credible with the big wigs.

Fast forward several months, and we were notified about a new compensation plan that put all family physicians on the same compensation model. We have equal base salaries and there are quality incentives that allow us to increase our total compensation. (That is a different conversation.)

With the implementation of this new compensation model, family physicians in the organization are paid the same regardless of gender. I felt it was a win. I was proud of the organization’s attempt to make things equitable for everyone.

This success wasn’t the result of my efforts alone, but my voice was heard in the C suite. In the end, it is the result that matters.

How family physicians can advocate for pay equity

So how do we move forward? We can all be agents of change. If you have concerns about pay inequities, or any inequity within your clinic or organization, consider these steps:

Finally, but most importantly, do not give up.

Jessica Triche, MD, is director of clinical services at ECU Health Family Medicine Center. She is a member of the AAFP Commission on Education and a past president of the North Carolina AFP.