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The First Step: Pay Equity in Medicine

Philip Seo, MD, MHS  |  Issue: October 2018  |  October 18, 2018

“Men work harder than women.”

My mother is a pediatrician, and I have two sisters—one is a dermatologist, and one is a real estate attorney. Therefore, I think understandably, this message took me by surprise. Of late, I have been particularly awed by my lawyer-sister, with whom I catch up when she is taking the 7:45 p.m. commuter train home to care for her two children. By that time, I am often already home with my feet up, drinking a beer.

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The message, however, was unavoidable. My cell phone was experiencing status epilepticus, vibrating urgently with updates regarding the initial message—and then with rapid-fire commentary regarding that initial message.

The Dallas Medical Journal is the primary publication of the Dallas County Medical Society, which counts the majority of physicians practicing in the Dallas area among its members. According to its website, the Dallas Medical Journal “includes practical advice regarding the business of medicine, profiles on member physicians, legislative updates … .”1 In September, in honor of Women in Medicine month, the editors elected to dedicate the issue to women in medicine, focusing on “cracking the glass ceiling” and “pay inequality between the sexes.”

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Big mistake.

Not the topic, mind you. As with all things, however, the devil is in the details. In this case, in advance of the September issue, the Dallas County Medical Society queried its members thus: “According to a Wall Street Journal article, salaries of women physicians are about 65% of their male counterparts’ salaries. We asked our physicians if they believe a pay gap exists between male and female physicians. If so, what is the cause? What steps can physicians take as individuals and as a community to address this?”

Dr. Gary Tigges, an internist in Plano, Texas, responded: “Yes, there is a pay gap. Female physicians do not work as hard and do not see as many patients as male physicians. This is because they choose to, or they simply don’t want to be rushed, or they don’t want to work the long hours. Most of the time, their priority is something else … family, social, whatever. Nothing needs to be ‘done’ about this unless female physicians actually want to work harder and put in the hours. If not, they should be paid less. That is fair.”2

The Internet then exploded.

Perhaps in the era before the World Wide Web, these comments might have passed unnoticed: transmission would have been limited to a handful of copies. Back in the day, it took a certain energy of activation to rip the offending page from a journal, add some choice epithets and then shove it in an envelope addressed to your best friend, marked with an ancient talisman called a postage stamp.

If around one-third of practicing female rheumatologists are telling us that knowing what they know now they would not have chosen to specialize in rheumatology, then our workforce issues are even more dire than we had suspected.

The Furor

That was then. As far as I can tell, the deluge started with Aletha Allen, a pediatrician in Winchester, Va., who tweeted: “If anyone knows Dr. Gary Tigges in Plano, Tx, please tell him that he’s just pissed off a few thousand HARD WORKING women physicians. Because, you know, quotes like this tend to get shared a lot on social media.”3

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Filed under:OpinionProfessional TopicsRheuminationsSpeak Out RheumWorkforce Tagged with:CompensationDr. Gary TiggespaySalaryworkforce shortage

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