A Structured Compensation Plan Improves But Does Not Erase the Sex Pay Gap in Surgery

Area of Science:

• Medical Economics
• Surgical Department Management
• Health Equity

Background:

• A significant sex pay gap persists in academic surgery, with male physicians earning substantially more than female physicians.
• Increased salary transparency is a proposed solution to mitigate these disparities in physician compensation.

Purpose of the Study:

• To investigate the impact of a newly implemented structured compensation plan on the sex pay gap within a large academic surgery department.
• To assess changes in surgeon salaries and their relationship to productivity metrics before and after the compensation plan's introduction.

Main Methods:

• Compared total compensations of 44 surgeons (33 men, 11 women) before and after a new structured compensation plan.
• Analyzed salaries against Association of Academic Medical Colleges (AAMC) medians, stratified by sex, specialty, region, and academic rank.
• Calculated and compared work relative value units (wRVUs) for all faculty, stratified by sex.

Main Results:

• A pre-existing sex pay gap was evident, with male surgeons earning significantly more than female surgeons despite similar work relative value unit (wRVU) production.
• The new compensation plan did not significantly alter male surgeon salaries.
• The structured compensation plan led to a significant increase in female surgeon salaries, thereby reducing the pay gap.

Conclusions:

• Structured compensation plans can effectively narrow the sex pay gap in academic surgery departments over a short timeframe.
• Enhanced transparency in surgical compensation structures is crucial for achieving equitable pay for all surgeons.