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A Structured Compensation Plan Results in Equitable Physician Compensation

A Single-Center Analysis

      Abstract

      Objective

      To assess adherence to and individual or systematic deviations from predicted physician compensation by gender or race/ethnicity at a large academic medical center that uses a salary-only structured compensation model incorporating national benchmarks and clear standardized pay steps and increments.

      Participants and Methods

      All permanent staff physicians employed at Mayo Clinic medical practices in Minnesota, Arizona, and Florida who served in clinical roles as of January 2017. Each physician’s pay, demographics, specialty, full-time equivalent status, benchmark pay for the specialty, leadership role(s), and other factors that may influence compensation within the plan were collected and analyzed. For each individual, the natural log of pay was used to determine predicted pay and 95% CI based on the structured compensation plan, compared with their actual salary.

      Results

      Among 2845 physicians (861 women, 722 nonwhites), pay equity was affirmed in 96% (n=2730). Of the 80 physicians (2.8%) with higher and 35 (1.2%) with lower than predicted pay, there was no interaction with gender or race/ethnicity. More men (31.4%; 623 of 1984) than women (15.9%; 137 of 861) held or had held a compensable leadership position. More men (34.7%; 688 of 1984) than women (20.5%; 177 of 861) were represented in the most highly compensated specialties.

      Conclusion

      A structured compensation model was successfully applied to all physicians at a multisite large academic medical system and resulted in pay equity. However, achieving overall gender pay equality will only be fully realized when women achieve parity in the ranks of the most highly compensated specialties and in leadership roles.

      Abbreviations and Acronyms:

      ACC (American College of Cardiology), FTE (full-time equivalent)
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      Linked Article

      • Physician Equity II
        Mayo Clinic ProceedingsVol. 95Issue 5
        • Preview
          We read with interest the article by Hayes et al.1 The gender pay gap is a well-traveled narrative in many professions, including academic medicine, in which the average male physician earns almost $12,000 more than their female counterparts even after adjusting for tenure, rank, years at rank, and clinical duties.2 As explained in the article, unlike many academic medical centers, Mayo Clinic compensates physicians according to an equitable stepwise salary progression model over a 5-year period, with the maximum target compensation based on specialty and the number of years postresidency.
        • Full-Text
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      • Physician Equity I
        Mayo Clinic ProceedingsVol. 95Issue 5
        • Preview
          Differences in compensation between male and female physicians are persistent, and the reasons for these differences are not fully understood.1 Hayes et al2 reported the potential for a structured, salary-only plan to achieve equitable compensation in an academic medical system. They concluded that overall gender pay equality—across practice settings and specialties—will require that women are proportionally represented in highly compensated specialties as well as leadership roles in medicine.
        • Full-Text
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      • In reply—Physician Equity I and II
        Mayo Clinic ProceedingsVol. 95Issue 5
        • Preview
          We appreciate the comments and analysis provided by Lifton,1 who found that among most member boards of the American Board of Medical Specialties, gender composition of the directors closely matched, and in a number of cases exceeded, the representation of women in active practice in the specialty. Arguably, and a point made in the cited Walker et al reference,2 a better goal might be “overrepresentation” of women directors so as to be more representative of the near-future workforce and closer to the proportion of women in training.
        • Full-Text
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