If only I had known...And what I would do differently. 7 lessons on how not to be a part of the statistic of Gender Pay Disparity.

Do men and women physicians get paid differently?

Some would say yes. Some would categorically deny that such a thing exists.

Like most things, I suspect the answer is somewhere in between. 
That it does exist in many practices, and there may be some that are very fair.
How would you know? 
And what can you do about it?

In this episode, I talk about 7 things I wish I had known at the beginning of my career that I would have done differently. 

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Transcript

0:10

Is there a pay gap between women and men anesthesiologists? This was a question that recently sparked robust debate on one of the discussion boards I am a part of. Several studies, albeit with some limitations have shown it does exist. There are also studies from other specialties, and of course it's a widely known fact in the corporate world that such gender pay gaps exist. What surprised me was the number of responses from several male colleagues who insisted that this is a myth that pay is fair across the board in all the institutions and the private practices they work in. And women may only be paid less because they're working less by choice because they choose to take care of their families. And men, because they're picking up the slack naturally, then will be paid higher. So gender pay gap does not exist in anesthesia according to these people. I beg to defer. And this makes my blood boil. Why? Because even though there may not be studies with a hundred percent people responding and lots of numbers and lots of figures, We know these gaps exist and we know it exists because none of the institutions, or I should say most of the institutions that I've heard of or I've worked in, have no transparency in pay. So how do you know it's fair when you don't even know what your colleagues are making? Now, I'm sure there are practices that exist where it is completely above board and fair, but to say that every practice is fair is I think delusional. The motherhood penalty is a thing if you haven't heard about the motherhood penalty, it's where women remain more likely than men to take time away from the workforce or to reduce their work hours because of care giving responsibilities. I happen to think there's also a woman penalty where for many reasons, including the fact that we don't negotiate for ourselves, and for that I blame us. We may be getting paid less. Can I a hundred percent say that's true? No. But from my own experiences and talking to a lot of people, that's what I'm finding. So how do we change this narrative? How do we change this narrative? This is the Leadership Prescription podcast and I'm your host, Dr. Asha Padmanabhan. I'm a full-time working anesthesiologist and a leader and a coach. I coach women Physicians in essential career and leadership skills like effective communication, conflict resolution, and negotiation so that every one of us can thrive in our careers and feel fulfilled, and we can do that without sacrificing our family life. So does a pay gap exist? And if it does, what can we do about it? Although we may not have the studies, there are several things that we as women Physicians can do to make sure that we are being compensated fairly and we know what's what. My first job out of residency was at a renowned academic institution. Now, why am I telling you this story is because I believe that my story will resonate with many of you who probably have done the exactly same, the same things that I have done, and I want to encourage every women physician starting out that it doesn't have to be that way for you. And so that's why I'm starting with my. So, as I said, my first job out of residency was at a renowned academic institution. I accepted the contract they gave me. I trusted them when I was told that this was what everyone made starting out, and that was probably true. There was no discussion at that point about promotion. I didn't know to ask, nor were there are any opportunities to ask about increased pay. As a newly minted physician, I was thankful for getting that first non-resident salary and I didn't know to negotiate or ask for anything different, and I was naive enough to trust in the system and think that everything is above board and fair and that everyone makes the same At the level that I was at. Two years in, I finally asked what I needed to do to proceed up the ladder academically with promotions and pay. And I was told I needed to publish something, so I did. Uh, and, but then just as I finished that publication part, my husband and I decided to move to Florida. There being no academic institutions. When I was moving, I started the rounds of interviews with private practices. I still had no idea about negotiations. I was still in the naive mindset that whatever I was being offered was what everyone at that level was making. And so when I compared all the offers I had, it was with that belief. I ultimately decided to go with a lower paying, starting salary, but with a carrot of a partnership at the end of three years with a increased salary. And that's in quotes because what that amount was was vague and it was based, I was told on whatever the collections would be At that point, again, I was too uneducated in the finances of practices, in collections and in practice management to ask more educated questions, and I trusted that everything was fair and above. Now I count myself lucky because a twist of fate did lead to me becoming partner at the end of my three years, unlike several of my peers who did not and were told they couldn't, but that's another story. Anyway, I became a partner, but even after becoming a partner, I had no idea about the finances, and I was told my partner salary now would be an X amount. I was happy with that, considering it was a significant jump from my non-partner salary. It was only after the managing partner left and I took over as treasurer that I finally began to understand the nuances of salaries and compensations and of bonuses, and that was eye-opening because things were definitely not as I had imagined. Soon after my group lost a hospital contract to a large group, as the winds of change swept through South Florida of small independent groups, been taken over by large companies, and I left that job and I joined another group as an employee again when I was offered my contract. I did ask, is there room for negotiation? And I was told, No, this is what it is, and I happily signed the contract. That was the extent of my negotiating for myself. The following year, I decided to take the leap that I had talked about in my previous episodes where I. Applied for and was accepted as into the position of chief of anesthesia for small community practice employed by a large national group. And again, I accepted the standard line that this is the base salary that everyone at the practice makes and you will make that plus the chief stipend. And I'm sure that was true. That was what I believed, that that was it. There was no other room for negotiation and there was no where else to go with that. Even as chief, salaries were not transparent, I continue to believe in the myth of fair until several job changes. And a couple years ago, several things happened, which opened my eyes to the possibility that there possibly could be other factors at play. As I found out from other people I had met and also from random remarks, by younger male colleagues about what they had negotiated that opened my eyes. And then there was a discussion that I was part of at a negotiating workshop where one of the participants told us how one of her male colleagues had a standing meeting every single year with his chief to negotiate a race. That was mind blowing. Here I was 10 years into practice and I had never negotiated anything for myself, even not a raise. And as I looked around the room, several women, Physicians said the same thing. They didn't think it was possible. Now, this guy might not have gotten a raise every single year, but he did have that opportunity to present his worth. And whatever comes out of making sure you know the powers that be, know that you are ready and willing to do more to earn. I'm sure he was given opportunities to do that, where none of the rest of us in the room had ever even thought to ask and to think that I had never thought there was a possibility. So again, here are the lessons I have learned, which I wish I had known from the beginning, and I hope those of you who are listening to this can take. And apply Lesson number one. Know your own worth. I cannot stress how important this is. Every single job I had taken up to this point, I was thankful that I was given the opportunity and I felt lucky to get the job. Lots of imposter thoughts and feelings. If you've listened to some of my other episodes, you might know that this is where we women Physicians really struggle. We struggle to know our own worth. I wanna tell you something. You are not lucky to get the job. They're lucky to have you. You did not get the job, and you did not get the pay because of someone's kindness of heart. You got it because you deserve it. And you may likely deserve more. Now this is the one that is going to take the most amount of work from you. I cannot stress how important this is because I know from my own personal experience and from that of many women, Physicians, I have coached that this is where we fail the most in not believing in our own self worth. So do whatever it takes to start believing, whether that's hiring a coach, doing. Work on yourself doing work on your imposter thoughts, knowing your own worth is where it all stops. Number two, know that everything is negotiable. A lesson, it took me many years to learn. Everything is negotiable. May not be to the degree that you want it, but there's always. They tell you everyone is being paid the same. That may be true about the base pay, but what about opportunities to make more? What about fellowship stipends? What about productivity bonus? What about compensation for any extra work for committee involvement? Now, some of these may not be monetary. It may be in the form of time, but that's still fine. You don't know until you ask. Lesson number three, ask for details if you're joining a private practice and get told that you will make more when you become a partner. Ask what the partners make on average, even if they can't give you specific. Ask what the ballpark has been in the last five years and ask what you need to do to get there and be very clear on whatever it is you need to do to get there. Don't fall into the trap. Several of my colleagues fell into where they assumed that they were doing everything that they needed to be do to become partner, and at the end of the time were told they could not. So ask, Ask for details. Number four. Form a peer group. One of the best ideas I have heard from one of the conferences that I've been to was from a woman lawyer who said that early on in her career, her and a group of friends formed a group where they promised to be honest with each other and transparent about what they were making. I'm sure this will be frowned upon, but this is the way that they learned that they could. Figure out as they rose in their careers, what the compensation was comparatively. And if they found out what the compensation their male colleagues were receiving, then that was added into the mix as well. So form a peer group and the earlier on you start in your career, the better. But wherever you're in your career form a peer group that promises to be transparent with each other. Number five, get educated on the finances of your practice, about RVs, about how you get paid. How does your clinical work turn into compensation? What do you need to do? What do you need to do if you have to start building a practice from scratch? What does it mean if you're taking over existing patients? Medical school and residency does not teach us this, but there are plenty of resources out there that can help you. There are courses, there are YouTube videos, there are tons of stuff out there that can help you figure out the finances of medicine. I truly believe that every residency and every medical school should teach the finances of medicine, but they don't. So it's upon us to help ourselves and to learn. And there is no excuse for you not learning, because now with the internet, everything is available for you to learn. So learn about your practice, learn about your compensation. Learn about how your clinical work translates into. Number six, read about negotiations. Take classes, read books. of my favorite books is the one that, I forget the author now, but I will put it in the show notes, which is about women Don't Negotiate. Women Don't Ask, I think is the title, and I'll put it in the show notes, but read that book, Take courses, learn, Get a coach, whatever it needs. To negotiate for yourself. I hired my first coach expressly to help me negotiate better for myself and all my subsequent coaches have really helped me with this. Starting from the mindset piece, starting from my imposter thoughts and my beliefs, and also going into what it is that I need for myself that I need to negotiate for. So do whatever it takes to learn how to negotiate better for. Number seven. Lastly, this may be a pipe dream, but I hope one day pay is transparent in all organizations that we are part of. So this is no longer an issue. This is no longer a debate about if gender pay disparity exists and why. So whatever you can do as you climb up in your organization, try to make this. I met someone at a conference recently who's fairly senior in her practice, and she makes it a point to sit down with every physician interviewing for a job and be transparent on what they can expect for compensation five, 10, and 15 years down the road. What it would be if they work full-time, what it would be if they choose to go part-time, and I wish more Physicians were like, And I wish I had known to ask these questions, right? For my first job interview. I wish someone had given me these six or seven points when I first started, but since I didn't, I wanna be there for you and give you that so you can be your best self and learn to negotiate for yourself. You can be your best advocate and learn to negotiate for yourself. So my own journey. After coaching and learning about myself, learning how to advocate better for myself, I have started negotiating better for myself. Have I gotten everything I asked for? Absolutely not. Have I gotten some things I've asked for? Absolutely. Yes. And that's a start. So if there's one thing I hope you take away from all this, it is to learn that you are worth every cent and more that you are earn. You need to believe it. You need to take the steps. So that you are not part of the statistics of earning less than your peers, than your male peers. Thank you for listening and if you wanna learn more about how you can be coached, you can take advantage of my complimentary coaching call. To ask me questions or you can sign up for the wait list for my 12 week Women Physicians Rising, Accelerate a group coaching program where I teach you all these skills that I have learned. Thank you.