A report in Retina Today, entitled, “A new perspective on the retina wage gap”, by Aidan Gilson, BS and Ron Adelman, MD, MPH, MBA, showed that disparities between male and female retina specialists exist. Their report, based in the USA, has summarised that:
- In 2020, female retina specialists received only 65 cents on the dollar in total annual payment through Medicare* compared with male retina specialists; *a federal health insurance programme in the US for those >65 years of age and younger people with disabilities.
- Both married female physicians and female physicians with children work, on average, fewer hours than the respective male physician population.
- The extra time female physicians spend with patients can lead to increased rates of preventive care, lower patient volume, and higher patient-reported experiences of empathy from their care provider.
- We must always be careful when examining multifactorial issues such as gender inequity because an oversimplification of the causes and outcomes can be misleading.
The report was an abridged paper entitled, “Disparity in Medicare Reimbursement Between Female and Male Vitreoretinal Surgeons”, published in the Journal of VitreoRetinal Diseases, December 23rd, 2023 (doi:10.1177/24741264231215532). The conclusion of their peer-reviewed paper was that the average female vitreoretinal surgeon receives only two thirds that of the average male vitreoretinal surgeon. In addition, “there was no identifiable improvement in this disparity over the study period” (years 2013 to 2020). The authors commented that, “further efforts must be taken to establish concerted efforts to improve the reimbursement disparity and to identify the systematic inequities that led to its presence in the first place”.
In terms of experiences of empathy, the authors stated that “female physicians, regardless of specialty, spend more time, on average, with each patient than male physicians. Some research suggests this may be related to differing patient expectations, with the assumption that female providers should spend more time with patients compared with male providers. As physician compensation is often directly linked to the throughput of services provided, spending more time with each patient can have negative effects on a female provider’s total compensation”. In addition, research shows that the extra time that female physicians spend with patients “can lead to increased rates of preventive care, lower patient volume, and higher patient-reported experiences of empathy from their care provider—all of which contribute to lower rates of litigation for female versus male physicians”. In summary, female retina specialists appear to be “compensated at a lower rate, despite providing exceptional patient care”. Further, the authors reported that less than 30% of first or last authors in retina publications are women and female ophthalmologists appear to receive less national funding and less likely to be represented in senior academic positions. The researchers’ concluding comment was that “[t]he wage gap is just one piece of a very large puzzle. Hopefully, further research will reveal other factors so that we can adequately address these issues”.