Salary Inequity and Me: A Personal Reflection

I stumbled upon the fact that I was the lowest paid surgeon in the department. I am triple board certified in general surgery, critical care, and hospice & palliative medicine. Nine years into my job as an attending surgeon, after some coaxing from a colleague, I decided to compare my salary to that of general surgery colleagues working at the same facility (all of whom, at the time, were men with children). During the years that I worked as an attending surgeon, I assumed I earned an appropriate and comparable salary for my work, and never gave my income much thought.

This same (male) colleague informed me about a website that allows one to search salaries of government employees by name. When I first looked at this website in 2017, I was practicing general surgery and critical care. I discovered that my colleagues who were practicing only general surgery, who were board certified in only one specialty, and who joined the facility after I did, all earned significantly more than me—by a wide margin. There was a $20,000 salary gap between me and the lowest paid surgeon in our group of five general surgeons, and a $125,000 salary gap between me and the highest paid surgeon in our group, who also had a leadership role. When I asked my surgeon colleague if the salary listed for him on that website was correct, he noted that the information was two years old and that it did not reflect his recent pay raise!

The salary discrepancy took me by surprise. Ultimately, feelings of disbelief gave way to anger. A $20K gap is significant, especially considering the loss in retirement earnings alone. The sheer unfairness angered me. I worked hard as an intensivist and functioned as director of the surgical ICU. I led an array of quality improvement initiatives over the years and worked with different clinical departments and divisions to make significant system-based improvements. I launched surgery morbidity and mortality conferences. I published a surgery handbook/guide for residents and faculty. I helped create electronic order-sets and protocols. I strove to improve the care provided for patients in the ICU and obtained approval from hospital leadership to hire more ICU personnel (nurse practitioners) to provide night-time coverage and dedicated care for the sickest patients. So why was I toiling under a wide pay gap?

This was the first job I had accepted after completion of fellowship training. At the time, I knew nothing about salary negotiation. This topic never once came up during residency or fellowship training, despite the fact that it has the potential to greatly impact a person’s life.

Though I had read about salary inequity issues affecting women in various fields, it never occurred to me that I would be among those afflicted with unfair payment practices. Like many women, I was grateful for my job and the security it brought. For nine years, blissfully unaware of being paid less than my colleagues, I went to work each day, bringing my best self to the task at hand—providing care for patients.

Some physician colleagues might roll their eyes and say “put on your big girl pants,” or “men who negotiate deserve to be paid more,” or “women should not whine—if you work less, you will be paid less.” But women who work equal hours and who are equally or more productive than their male colleagues ought to be rewarded by salary parity. However, there is much evidence in the published literature to the contrary—women often get paid less for doing the same jobs as male colleagues.

My book ‘Being a Woman Surgeon—Sixty Women Share Their Stories’ published in 2015, comprises personal stories and revelations by women in surgery. Leaders in the field wrote that they were shocked to find inexcusable salary discrepancies between men and women when they became department chairs. One even described how men in her department regularly asked for salary increases, whereas the women in her department never raised the issue.

Despite knowing this, however, it never occurred to me to compare my...