Even if you can’t see sexism immediately, it’s still there

For the most part, the sexism in medicine is not subliminal at all — it’s quite overt. Unless you’re a female physician, you probably are unaware that it’s still an ever-present reality for us. I want to note that there are very good men out there who are trying their best to be advocates for equality in our field even though they cannot fully appreciate the female physician plight. My father is one. My husband, an anesthesiologist, is one. The male physician-entrepreneur I met with last week to discuss a partnership in my new solo practice with his clinic system is one. These men are the “He’s for She’s” of medicine. And yet, the hurdles are massive even once we women have finally made it to attending status.

Examples of overt sexism abound. As this article notes, the pay discrepancy for the same job and hours worked is blatant (>$100,000 difference). Physicians in specialties such as ER and anesthesia may not appreciate this, as their shifts might be salaried per hour. However, in fields that don’t require a lot of face-to-face patient care and fields which weigh “productivity” (aka patient face-to-face volume and turnover) heavily in the pay, women are often paid significantly less. I’d contend it’s because, in many non-procedural fields, females more often take the time necessary for patients despite the sacrifice to their productivity earnings. We women, frankly, tend to care more about the patient than our paycheck. And yes, there is evidence to back this up. A Harvard study released in JAMA this year showed conclusively that elderly patients admitted to the hospital had lower death rates and readmission rates when treated by female internists compared to their male counterparts. While the numbers are overt, the subliminal sexism is written into the RVU methods of physician reimbursement. Those who care enough to take the time to do the job well inevitably get punished financially.

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