How and why does the pay gap between male and female otolaryngologists exist, and what can be done to achieve gender pay equity?
BOTTOM LINE
Achieving professional equity, including gender pay, in otolaryngology will require efforts on multiple fronts, including organizational culture, resource allocation, and compensation transparency.
BACKGROUND: Despite years of legislative efforts, gender pay inequity does not yet exist in the U.S. Data show that the medical field has one of the highest gender-based pay gaps, with a particularly wide gap among otolaryngologists, even after accounting for age, experience, faculty rank, research productivity, and clinical revenue.
STUDY DESIGN: Literature review.
SETTING: Department of Otolaryngology–Head and Neck Surgery, Harvard Medical School, Massachusetts Eye and Ear, Boston.
SYNOPSIS: Despite legislative efforts, the gender-based pay gap persists. Women have accumulated 32% of the wealth accumulated by men over time, decreasing the ability to pay off educational debt and achieve financial security in retirement. Inequity in physician pay is particularly problematic. A report by the Association of American Medical Colleges has female otolaryngologists earning 77 cents for every dollar that their male colleagues earn. Pay gaps exist even after accounting for age, experience, specialty, faculty rank, and measures of research productivity and clinical revenue. Past explanations for the inequity, such as reduced work hours/productivity or the notion that women don’t negotiate their salaries, are false. A literature review reveals actual causes: unequal distribution of resources, gender bias and discrimination, organizational culture and maintenance of status quo, and lack of transparency in equity review processes. The author proposes that otolaryngology departments create, communicate, and uphold goals and policies designed to address gender inequities and biases, create a standardized system to ensure equitable resource allocation, take steps to ensure promotion equity, and adhere to a transparent equity review process.
CITATION: Lindsay R. Gender-based pay discrimination in otolaryngology. Laryngoscope. 2021;131:989-995.