a group of Mayo Clinic residents and physicians on medical rounds

ROCHESTER, Minn. — Gender
pay equity in the field of medicine remains elusive. Gender-based pay differences
have been shown to persist, even when controlling for experience, clinical
productivity, academic rank and other factors. These inequities result in
significantly lower lifetime earnings, job burnout and negative attitudes
toward work, and adverse effects on the profession and society.

One model for eliminating pay disparities among physicians is a structured, salary-only plan that incorporates national benchmarks, and standardized pay steps and increments, such as the plan that is used at Mayo Clinic.

A Mayo Clinic study set out to assess how well the institution adheres to its own compensation model and achieves pay equity. The study reviewed data for all permanent staff physicians employed at Mayo Clinic destination practice sites in Arizona, Florida and Minnesota who were in clinical roles as of January 2017. Each physician’s pay, demographics, specialty, full-time equivalent status, benchmark pay, leadership roles and other factors were collected and analyzed.

Among 2,845 physicians, pay equity was affirmed in 96% of the cases, according to the analysis, which is published in Mayo Clinic Proceedings. All physicians whose salaries were not in the predicted range were evaluated further and found to have the appropriate compensation, most often due to unique or blended departmental appointments. Of the 80 physicians — 2.8% of the total — with higher compensation than predicted by the model, there was no correlation with gender, race or ethnicity. The same was true of the 35 physicians — 1.2% — who had lower-than-predicted compensation.

“Our analysis is unique and to our knowledge the first to demonstrate that a structured compensation model achieved equitable physician compensation by gender, race and ethnicity, while also meeting the practice, education and research goals of a large academic medical center such as Mayo Clinic,” says Sharonne Hayes, M.D., a Mayo Clinic cardiologist and the study’s first author. “The analysis of this long-standing salary-only model was reassuring, not only that it was equitable, but that we as an organization adhere to our own standards.”

A structured compensation
program has been used for physician salaries at Mayo Clinic for more than 40
years to remove financial incentives to do more than is necessary or less than
desired for the patient. The step-based model is designed to ensure that
salaries are market-competitive; advance efforts to recruit and retain staff;
and support the mission, vision and values of the organization. There are no
incentives or bonus pay, and nonsalary compensation and benefits are consistent
across Mayo Clinic locations and specialties.

Of the 2,845
physicians whose compensation was analyzed, 861 were women and 722 were
nonwhite. More men than women held one of the compensated leadership positions
or had past leadership roles — 31.4% of men were in that category, compared
with 15.9% of women — and more men than women were in the highest compensated
specialties.

The study calls for
health care organizations to systematically define the drivers and incentives
of physician compensation, and assess whether these organizations unfairly
exclude or disadvantage certain groups — whether women, racial or ethnic
minorities, or medical specialties — and then develop processes that can
achieve equity and values alignment.

“While solutions to persistent pay inequities are different for each organization, leadership must be committed to addressing those inequities by identifying and consistently tackling biases,” says Gianrico Farrugia, M.D., president and CEO, Mayo Clinic, and a study co-author. “Furthermore, absolute gender pay equity will only be realized when women achieve parity in the most highly compensated specialties and leadership roles.”

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About Mayo Clinic Proceedings
Mayo Clinic Proceedings is a monthly peer-reviewed medical journal that publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research, and clinical epidemiology. Mayo Clinic Proceedings is sponsored by the Mayo Foundation for Medical Education and Research as part of its commitment to physician education. It publishes submissions from authors worldwide. The journal has been published for more than 90 years and has a circulation of 127,000.

About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and An Inside Look at Mayo Clinic for more information about Mayo.

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