Pay inequality in PA profession....gender related.

[physasst]

Interesting study in JAMA.

 

http://archinte.jamanetwork.com/article.aspx?articleid=1733450#ild130129t1

 

Pay gap between male and female PAs went from:

 

7.6% in 1987-1990

 

to

 

19.4% in 1996-2000

 

to

 

29.3% in 2006-2010

 

STARK.....By way of comparison, physicians only increased slightly from 20.0 to 25.3 %

 

Nurses and pharmacists reduced the pay gap. Dentists remained roughly the same.

 

Health insurance executives and NON health care workers also dramatically reduced their pay disparities over the same time interval.

 

But we PAs had the BIGGEST increase.

 

This is a limited study, so inferences are limited, but it raises some rather poignant issues, and at the very least calls for some much more intensive national research.

[CAdamsPAC]

"And"??????

[EMEDPA]

how much of this is due to the fact that many women work part time and/or take off big chunks of time to have kids?

no ads say "male pa 50/hr, female pa 40/hr".

all the pas in my group work for the same pay rate but in the last several years several women cut back to part time and most have had kids in the last few years and taken off 3 months or so when the kid was born(as well they should. dad's should too but often don't).

anyway, my point being if you tracked pa yearly wages in our group you would see that all the top producers are men. it's not that we discriminate(far from it) it's just that many women self select to work less.

I didn't read the study but did it look at $/hr or $/year which would be a lot less accurate?

people are worth what they think they are. if someone offers you a bad salary just don't take it. look elsewhere. if enough folks do that the rates will increase to the community standard.

[rcdavis]

how much of this is due to the fact that many women work part time and/or take off big chunks of time to have kids?

no ads say "male pa 50/hr, female pa 40/hr".

all the pas in my group work for the same pay rate but in the last several years several women cut back to part time and most have had kids in the last few years and taken off 3 months or so when the kid was born(as well they should. dad's should too but often don't).

anyway, my point being if you tracked pa yearly wages in our group you would see that all the top producers are men. it's not that we discriminate(far from it) it's just that many women self select to work less.

I didn't read the study but did it look at $/hr or $/year which would be a lot less accurate?

people are worth what they think they are. if someone offers you a bad salary just don't take it. look elsewhere. if enough folks do that the rates will increase to the community standard.

 

Agree with above. In almost 4 decades of doing this, I have NEVER. Seen a disparity of pay based on gender...

 

Pay differences have been productivity based, hours available, hours worked. But never based on gender.

 

In a couple places we have started less experienced PAs on a straight salary until they beacon e comfortable with the EMR and the facility's unique logistics... In order to protect them by assuring a stable salary during the low production acclimation period.

 

Bonuses usually are tiered to hours worked and RVUs produced.. Which disadvantages working moms.

 

But, as e said, I have not seen, nor been aware of gender disparity.

 

As an aside, the male female ratio in the profession has changed from 80:20 to maybe 40:60 now. There are more females than males.

 

Maybe, in those places that due pay based on gender, males have become more "attractive"???

[EMEDPA]

when I started with my current group of 15 em pa's we had 13 men and two women. we now have 5 men and 10 women. This reflects recent changes in the applicant pool and admissions process with more women getting into and graduating from pa school. the last time I went to help out with pa school interviews there were 2 men in the room and I was one of them....and the guy( a medic) didn't make the cut for admission despite my yes vote.

The prior hce mix has gone way down as well. when I started with the group most of us were former medics(military or civilian) , nurses (lpn or rn) or RT's.

now all our most recent full time hires are former medical assistants and cna's. we also now have two former exercise physiologists(aerobics instructors-no kidding) it's the way the profession is going I guess.

[Corpsman2PA]

we also now have two former exercise physiologists(aerobics instructors-no kidding) it's the way the profession is going I guess.

Somewhere out there, Richard Simmons is smiling...

[physasst]

They did adjust for hours, from the paper:

 

We used median regression analysis to study trends in earnings across occupations, adjusting for age, sex, race, hours worked, and state. We adjusted for hours worked to avoid overstating gender differences in earnings if female physicians work fewer hours.

 

They were not however, able to adjust for specialty. So, if there is an unequal distribution of PAs by gender among specialties, that could not be examined. They did adjust for age, which was another thought of mine. Most female PAs are younger, while many of the male PAs are older. I thought perhaps that could account, but they adjusted for that.

 

Still, that would likely, at least statistically, only account for part of this difference. 29.3% is rather huge.

[EMEDPA]

they can't adjust for productivity though.

a 50 yr old em pa making 50/hr + production is likely seeing more pts/hr and doing more procedures with less physician involvement than a 22 yr old female em pa on the same pay scale.

[Guest JMPA]

they can't adjust for productivity though.

a 50 yr old em pa making 50/hr + production is likely seeing more pts/hr and doing more procedures with less physician involvement than a 22 yr old female em pa on the same pay scale.

 

thats a sexist statement. since when does age reflect competence or ability? some of the laziest incompetent people i have worked with were over 50 y/o

[EMEDPA]

age = experience in many cases. 50 yr old male vs 22 yr old male would be the same outcome.

that was my point.

if you compared Davis and I ( he is 10 or 15 years older than me) I'm sure his numbers would put mine to shame.

I run circles around any new grad of either sex. it's because I have been doing this for almost 30 years. I came on shift yesterday to see a male PA with 6 yrs of experience getting a consult on a young stable patient with SVT. dude, just give the adenosine. don't play mother may I, just do it. it's no wonder the docs don't trust this guy. that's what happens when you consult on no brainer cases.

[Guest Paula]

age = experience in many cases. 50 yr old male vs 22 yr old male would be the same outcome.

that was my point.

if you compared Davis and I ( he is 10 or 15 years older than me) I'm sure his numbers would put mine to shame.

I run circles around any new grad of either sex. it's because I have been doing this for almost 30 years. I came on shift yesterday to see a male PA with 6 yrs of experience getting a consult on a young stable patient with SVT. dude, just give the adenosine. don't play mother may I, just do it. it's no wonder the docs don't trust this guy. that's what happens when you consult on no brainer cases.

 

He needs you to mentor him, or the docs should be doing that so he will become an autonomous clinician. Or, he is in the wrong specialty and no one has suggested he look elsewhere. Or, he needs to complete an ER residency. Or, the school he went to taught very heavily on the "know what you don't know and refer". But this is another topic.

 

I actually agree with the EMPA and rcdavis on the female PAs may not work as long of hours, take less call, or are in specialties that pay less. In my mind there is no such thing as equal pay for equal work, since there is no such thing as humans who are equally same, think the same, do a procedure the same, etc., etc,. etc. Starting at the same hourly rate or base rate is expected, but the job morphs into your own and you will generate your own salary from then on.

[physasst]

Paula, you guys need to actually read the study. They adjusted for hours worked, age, sex, etc. There is still a HUGE disparity. This is a big problem. You are all looking at this through the lens of your own specialty, that's too myopic. This is in the aggregate.

 

While there may be some difference based on specialty, I cannot think of any way statistically, that it explains the 29% difference in pay, unless workforce distribution is much, much worse than any other data point we've collected.

 

A more appropriate criticism would be of the small sample size of PAs. Would be interesting to use the AAPA census data to look at this with a much bigger sample population.

[rocketpropelled]

I have to wonder how much might be related to the overall tendency of absent or passive compensation negotiations among younger women. A lot of research has been done in other fields showing that women, especially women in the earliest stages of their careers, tend to either not negotiate, or not negotiate aggressively, during the employment offer phase. Research also tends to show that your first job (or first few) sets the "anchor" for future salaries and negotiation.

 

In other words, what you worked for in your last job will set the range for the next job, and so forth -- this applies both to personal expectations of pay (you think working for less is standard), as well as sharing too much information with HR in the hiring process ("says here you worked for $35/hr at your last job. We'll give you $38! Be grateful!"). If the "base" is set lower due to poor negotiating in the first job or two, this has far-reaching consequences later in the career; when you spread this across an entire industry, it can create a skew in the numbers that looks a lot like this disparity. If a lot of people jump on the first offer, and/or don't realize it's a first offer, not a final one, and this carries on for 10+ years, this is how it can look. More importantly, if you take a low offer on your first job, it tends to affect the rest of your career (in the aggregate -- obviously, each professional has his or her own story).

 

With the curves exchanging between number of men and women in the PA work force (less men, more women), and an overall tendency (borne out in other industries) for acceptance of lower compensation earlier in the career, which tends to extend longitudinally throughout the career, this curve looks pretty natural.

 

I'd like to see the specifics of how career longevity, pay per hour, and gender were "adjusted" for. That can create a lot of skewed results.

 

(For the record, I'm just a lowly pre-PA applicant with an extensive business background and an MBA. I may have also stayed at a Holiday Inn Express last night.)

[dwolf]

I have not read this study, but anecdotally, there are many who are loathe to admit that there is pay inequality between genders; it seems that many of the comments here reflect such a sentiment.

 

We should accept reality, and only then cast doubt upon this study. To those who dislike this particular study, I suggest this line of thinking, and writing:

 

It is a fact that gender based pay equality is a sad reality in the USA; I also have no evidence to suggest that while such pay inequality exists in many (probably all) other professions, it somehow, spares the PA profession.

With that said, I do not think this particular study is accurate "insert reason."

[rcdavis]

I have not read this study, but anecdotally, there are many who are loathe to admit that there is pay inequality between genders; it seems that many of the comments here reflect such a sentiment.

 

We should accept reality, and only then cast doubt upon this study. To those who dislike this particular study, I suggest this line of thinking, and writing:

 

It is a fact that gender based pay equality is a sad reality in the USA; I also have no evidence to suggest that while such pay inequality exists in many (probably all) other professions, it somehow, spares the PA profession.

With that said, I do not think this particular study is accurate "insert reason."

 

sorry to infer that I didn't believe the study. I can only speak from on perspective: my own. ,and that perspective has been in PA hire-fire management for a l-o-o-o-o-n-g time. and I

I was responsible for the offeriung of PA salaries.

 

And, from my limitied perspective, (involving only Emergency Medicine and critical care/ ICU medicine, I did not see the pay disparities.

 

I do not doubt they exist.

 

but not in my world.

 

in fact, we just signed on a "firefighter" for my ED as we unexpectedly lost a new hire and will be short for 1-3 months. SHE will be making $10 more an hour than I am... plus getting travel pay and lodging paid for..

 

again, not in my very limited corner of the world.

[rcdavis]

AND, if the study is valid, and confirmed with a true representation of PA numbers, and equalized for type of job ( EM to EM, UC to UC, FP to FP, CTS to CTS), and if this pay disparity is true, THEN , I would suggest that some women PAs get together, sue their employers under title VII of the EEOC act, and try to get class action status, and fix this.

 

There are rather severe penalities to the employer if this study is true,

 

Which makes me wonder.....

[physasst]

AND, if the study is valid, and confirmed with a true representation of PA numbers, and equalized for type of job ( EM to EM, UC to UC, FP to FP, CTS to CTS), and if this pay disparity is true, THEN , I would suggest that some women PAs get together, sue their employers under title VII of the EEOC act, and try to get class action status, and fix this.

 

There are rather severe penalities to the employer if this study is true,

 

Which makes me wonder.....

 

It may not be within the same employer RC and it might be. Often it might be two private practice FP offices. One employs a male, another employs a female. Both are the same age and have the same experience and have the same patient mix. The male is paid 25k more. Two different employers.....yet, the female makes significantly less than the male despite doing the same job.

 

I suspect that this is what you might see if we had more granularity.

[rcdavis]

It may not be within the same employer RC and it might be. Often it might be two private practice FP offices. One employs a male, another employs a female. Both are the same age and have the same experience and have the same patient mix. The male is paid 25k more. Two different employers.....yet, the female makes significantly less than the male despite doing the same job.

 

I suspect that this is what you might see if we had more granularity.

 

hmmm. I can see that.

 

in the case of two entirely separate practices, in which there is no collusion, then there is nothing illegal. just , as another poster alluded to, poor negotiating skills.

 

I wonder if there is a pay differential in this practices which prefer women (plastics, derm, gyn)

 

rc

[primadonna22274]

I can believe the poor negotiation skills. Women are still taught that it's not nice or ladylike to talk too much about money. I'm guilty of this myself and just negotiated my first raise (hourly in ED per diem) in the past 5 years. I had to argue even though I KNOW one of the guys who had worked a couple years less than I had a higher base rate. Go figure, I had to plead my case with a WOMAN in HR and in fact took me bringing this up 3 times over 8 months and working 4 major holidays for regular pay (d'oh!) as per diem staff. I finally realized they needed ME as much as I need the hours and negotiation worked, but I wish it hadn't taken me so long.

[jsfelder0417]

Especially with your increasing knowledge and skills as an OMS!

[Davo]

Interesting study in JAMA.

 

http://archinte.jamanetwork.com/article.aspx?articleid=1733450#ild130129t1

 

Pay gap between male and female PAs went from:

 

7.6% in 1987-1990

 

to

 

19.4% in 1996-2000

 

to

 

29.3% in 2006-2010

 

STARK.....By way of comparison, physicians only increased slightly from 20.0 to 25.3 %

 

Nurses and pharmacists reduced the pay gap. Dentists remained roughly the same.

 

Health insurance executives and NON health care workers also dramatically reduced their pay disparities over the same time interval.

 

But we PAs had the BIGGEST increase.

 

This is a limited study, so inferences are limited, but it raises some rather poignant issues, and at the very least calls for some much more intensive national research.

 

 

I dont see a problem, the gap is due to a number of factors, and is seen even amongst physicians. Things like longer hours, and the ability to work OT are the likely reasons for the disparity.

[rcdavis]

See comment #7.. Physassist points out that these variables were accounted for.

 

And, if there IS this disparity, and it is intentional, then there IS a problem.

[SO4683]

I used to hear this same issue applied to law enforcement all the time. It was total nonsense. How many female cops were there in the 70s and 80s? As a result, what percentage of commissioned officers today are females that have decades of experience and are in the higher pay scales due to raises and longevity pay? Higher percentages of younger females simply equates to lower pay than those who have been around longer. I realize so-called "studies" state they adjust for age and account for all factors, but in the case of law enforcement it just isn't true. Law enforcement officers are public officials and their salaries are a matter of public record. The agency I worked for posted pay scales on their website! There is NO guesswork in discovering how much police officers make whatsoever. The female cops who started when I did made exactly as much as I did. So why is a "study" needed? Why, to justify the position that a pay disparity exists, of course. Given the transparency of police pay, there is no possible way for gender inequality. Yet time after time I heard the same argument that is being presented here for PAs and was backed by numerous "studies". As a new PA student, do I have any idea if there exists inequality in the PA profession? Absolutely not, but I can assure you that results of any pay inequality study these days, regardless of the occupation, is biased by the producers and they will find the result they want no matter what whether its equality or inequality. Remember the recent post here that stated a "study" found that facebook use results in poor health or something to that affect? How many people took that serious? But it was a qualified "study". I do truly hope that pay inequality in the PA profession does not exist, but I will not believe the results of a group with an agenda.

[Davo]

See comment #7.. Physassist points out that these variables were accounted for.

 

And, if there IS this disparity, and it is intentional, then there IS a problem.

 

Accounted for to a certain extent...Not mentioned for example is the fact that men tend to have more experience, and often work in higher paying specialties, have more direct care, and receive more funds for professional development.

 

I believe that this disparity is mirrored for many of the same reasons elsewhere in medicine. If its intentional-its not only a problem, its illegal.

[physasst]

Accounted for to a certain extent...Not mentioned for example is the fact that men tend to have more experience, and often work in higher paying specialties, have more direct care, and receive more funds for professional development.

 

I believe that this disparity is mirrored for many of the same reasons elsewhere in medicine. If its intentional-its not only a problem, its illegal.

 

That's the problem we don't know. The issue is that, if age were properly accounted for, and knowing the lead author of this study, it was, then we still have the problem of specialty, which they were unable to account for.

 

Here's the problem though. Statistically, only about 34% of PAs work in PC (IM, FM, Peds).....roughly 66% of PA graduates are women....(See Hooker, et al, this month in JAAPA) As of 2013, only 1/3rd of clinically practicing PAs are male. See the problem? Specialty alone, because of the large number of practicing PAs that are female, cannot explain away the difference. It's too big.

 

My biggest complaint was the sample size in this study for PAs was way too small. BUT, it suggests a possible problem and/or trend. As I said, it would be interesting to look at the AAPA census data and analyze these same questions with controls for age, gender, time in practice, specialty, and geographical region.

 

I don't think we can say the PA profession is horrible for this, but I also don't think we can simply dismiss this with pure conjecture or postulation. We need more data, with a much bigger sample population and better controls. That's my take home from this.