ACP: Position Paper Recommends Solutions to Close Gender Equity Gap

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The American College of Physicians published 8 recommendations to achieve gender equality in medicine.
The American College of Physicians published 8 recommendations to achieve gender equality in medicine.

The American College of Physicians (ACP) released a new position paper aimed at leading a cultural shift in gender equity in the medical field. 

While gender diversity has improved over the years in the healthcare profession, on average, female primary care physicians make 16% less than their male counterparts; specialists make 37% less. For women of color, that gap is even wider.

“We must recognize that implicit bias as well as sexual harassment exists in the medical profession and [we must] work to de-stigmatize reporting and promote culture change,” said Susan Thompson Hingle, MD, chair of the ACP's Board of Regents and lead author of the paper in an interview with Medical Bag. “We must help each other out by commenting when someone calls a woman by her first name and a man [as] ‘Doctor.' It is about being intentional, consistent, and persistent.”​

The ACP's 8 recommendations for achieving gender equity include promoting equitable pay, enhanced parental leave policies, implicit bias training, and gender compensation inequity research.

In a press briefing at the Internal Medicine Meeting 2018, held April 19-21 in New Orleans, Louisiana, Dr Hingle shared a personal example of gender-related inequality faced during her career.

Dr Hingle told the story of a work function at which she — recently elected to a national leadership role within the college — was referred to by a male colleague as “the princess of the ACP.”

“I think that's a great demonstration of implicit bias,” said Dr Hingle. “[It] was probably meant to be humorous, but that really impacted me on a personal level, despite on an intellectual level realizing that…my peers had thought highly enough of me to serve in this role. I started to question everything, including decisions…that had no relationship whatsoever to the work that I was doing. It was a great example of imposter syndrome.”

At the same press briefing, Sue S. Bornstein, MD, chair of the ACP Health and Public Policy Committee, added that there is “not any debate that there is a gap in physician compensation and gender equity. Depending on what study you look at, [it can be] as much as a 16% pay gap between male and female primary care physicians. The gap is wider for specialists. These gaps persist even after we adjust for factors like specialty, place of employment, and years of residency.”

In an accompanying editorial, written by Molly Carnes, MD, MS, University of Wisconsin-Madison professor of medicine, psychiatry and industrial & systems engineering, admits that a cultural shift of this magnitude doesn't happen overnight, but the ACP's positions are a large step in the right direction. She compared the ACP article to the Surgeon General's report from 1964 that sparked the cultural change that led to smoking laws.

“Data existed for quite a while on the health hazards of smoking, but having a clear statement from a high status source validated the need for change,” said Dr Carnes in an interview with Medical Bag. “It established a sense of urgency and importance and set the stage for the investment of resources into making it happen. It then took multi-level interventions at the individual and institutional level until we saw a systems change. Hopefully, the ACP report will do the same for gender equity.”

To view the full position paper, please visit the ACP website.

References

  1. Butkus, R, Serchen, J, Moyer, DV, Bornstein, SS, Hingle, ST; for the Health and Public Policy Committee of the American College of Physicians. Achieving gender equity in physician compensation and career advancement: a position Paper of the American College of Physicians [published online April 16, 2018]. Ann Intern Med. doi:10.7326/M17-3438
  2. Carnes, M. The American College of Physicians is working hard to achieve gender equity, and everyone will benefit [published online April 16, 2018]. Ann Intern Med.  doi:10.7326/M18-0837
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