Denial of Pay Gap Makes Women Physicians Roar

Wow. I knew social media was powerful, but I didn’t realize just how powerful until Dr. Gary Tigges’s infamous quote was made public this weekend (and we haven’t even seen the end result). I think this very situation is why my physician husband fears this entire blog and anything I say on social media.

The Instigator

On Friday, August 31st, the September issue of the Dallas Medical Journal landed in physician mailboxes across Dallas County (sent to all members of the Dallas County Medical Society). That evening, a physician involved in the Physician Moms Group on Facebook posted the now notorious quote for more than 71,000 physician moms to see.

Within a couple hours, more than 500 responses could be seen in this group alone. When it was reposted in other private physician mom’s groups, similar numbers of responses were accumulating. It was posted on Twitter and Instagram with the same result.

The Responses

Saturday afternoon, The Dallas Morning News (likely contacted by multiple PMGs) posted an article as a response from Dr. Tigges. To read the whole article, click here.

IMO, that response is half-assed at best. Yet, it isn’t at all remarkable when you see the comments he has made on Twitter in the past. (This has since been removed, but not before the screenshots were saved.)

By Saturday afternoon, the Dallas County Medical Society response was shared with the PMG.

Saturday evening, even GomerBlog had a rebuttal.

UPDATE AS OF SUNDAY, SEPTEMBER 2nd:

A response from Dr. Tigges on his practice page.

I’m not even sure what I think about this. Most of it sounds like “mansplaining” at its finest. The studies show that even when controlling for number of patients seen, etc, there still exists a MASSIVE pay gap in medicine. Plain and simple. His response just goes to show that he still doesn’t get it.

I think what pains many of us the most is that this man serves on the Medical Board for the Presbyterian Hospital of Plano and on their credentialing committee currently–how can he be expected to provide any kind of impartiality to his committees? How has someone like this become a “leader”?

Dr. Tigges spends his time doing “medical missions”, and somehow has a growing list of Google Image results with amFAR VIP Gala pictures. He obviously likes to rub elbow with celebs. (@KylieMinogue) I admire his dedication to amFAR, but his character/career suicide may limit those opportunities.

The Women Roar

But the real rebuttal comes in all of the most recent data regarding women in medicine–better outcomes, less pay, no matter the specialty or the hours worked. Those actual scientific articles can be seen here. I’m just posting the conclusions, but you can read more by clicking the links:

• Equal work for unequal pay (BMJ)
• • “After adjustment for how hard a physician works, his/her years of experience and his/her productivity, female healthcare providers are still reimbursed less than male providers. Using objective, non-survey data will provide a more accurate understanding of this reimbursement inequity and perhaps lead the medical profession (as a whole) towards a solution that can reverse this decades-old injustice.”
• Doximity 2018 Compensation Survey Results (Doximity)

• • “We also evaluated the differences in how male and female physicians were paid in 2017. In 2016, the average national gender gap among physicians was 26.5 percent less per year, and on average, female doctors made $91,284 less than what the average male doctor made.

• • In 2017, the physician gender gap remained stubborn at 27.7 percent, and female doctors earned $105,000 less than their male counterparts. In fact, in evaluating this data at the local level, more than half of the 50 metro areas saw the physician gender wage gap increase.”

Also, when women in medicine are providing better outcomes and working just as hard on the job, they are also going home and working their “second shift”. They are overloaded with household responsibilities, small chores, childcare, etc. Although it may be 2018, women are still held responsible for more than 50% of the work performed in the household.

• Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Doctors. (JAMA Internal Medicine)
• • “Elderly hospitalized patients treated by female internists have lower mortality and readmissions compared with those cared for by male internists. These findings suggest that the differences in practice patterns between male and female physicians, as suggested in previous studies, may have important clinical implications for patient outcomes.”

• Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. (BMJ)

• • “After accounting for patient, surgeon, and hospital characteristics, patients treated by female surgeons had a small but statistically significant decrease in 30 day mortality and similar surgical outcomes (length of stay, complications, and readmission), compared with those treated by male surgeons. These findings support the need for further examination of the surgical outcomes and mechanisms related to physicians and the underlying processes and patterns of care to improve mortality, complications, and readmissions for all patients.”

• Work-Family Conflict and the Sex Difference in Depression Among Training Physicians (JAMA Internal Medicine)

• • “Our study demonstrates that depressive symptoms increase substantially during the internship year for men and women, but that this increase is greater for women. The study also identifies work-family conflict as an important potentially modifiable factor that is associated with elevated depressive symptoms in training physicians. Systemic modifications to alleviate conflict between work and family life may improve physician mental health and reduce the disproportionate depression disease burden for female physicians. Given that depression among physicians is associated with poor patient care and career attrition, efforts to alleviate depression among physicians has the potential to reduce the negative consequences associated with this disease.”

On a side note, I will admit that I, personally, am not a victim of the pay gap. My group has an extremely transparent revenue sharing agreement with the related accounting spreadsheets emailed to us on a monthly basis. In addition, we get paid to work hard, bill more, and collect more. Having spent 10-16 days a month on call during my first child’s first year of life (I went back at 7 weeks postpartum), I make up a large majority of our billing and collections, and I get to reap the rewards. On the other hand, I’ve really enjoyed this first month of having my partner/husband back with me and working about half as hard. Instead of the equivalent of 75 hours a week I’ll be working the equivalent of 44. Yet, I will still reap what I sow, so will my husband, and so will all of my partners. Perhaps that’s what this orthopedic surgeon was referring to in the private world:

Yet, it’s not just Dr. Tigges that believes that the gender gap isn’t real. Ophthalmologists believe it as well (so it’s not just primary care)!

The ignorance is awful.

Where are we headed from here? 

Personally, I’m sitting tight. There are soooo many women responding–from bad reviews on Google, Yelp, Healthgrades, etc to letters to the DCMS/TMA, his associated hospital and its leadership, his practice (and its physicians) are already drafted and/or read. I suspect someone with such lack of integrity likely has the right connections to create a lawsuit. However, I do think he has provided the perfect platform for some actual change for women in medicine. Some of the groundwork has already been done. Check out these pieces for more information:

Whats Holding Women Back from Leadership in Medicine from the Harvard Business Review. A really great synopsis of all the reform needed to work towards gender equality in medicine (and other fields).

Women at the helm of the ACS: Charting a course to gender equity Finally, the surgeons are realizing that mentorship is lacking, and we, as females, have to mentor each other to further our progress.

Does Every Opinion Matter? Discussing Viral Postings and Meaningful Progress One of my favorite podcasts to listen to on a regular basis, and this episode is phenomenal. You it is candid and very real.

I can sum up the Physician Mom response to Dr. Tigges in 6 simple words: