Contraction Negotiations and Pay Raises: Policies to Close the Gender Wage Gap in Healthcare
In recent years, policymakers in multiple states have introduced legislation designed to close the gender wage gap and increase pay transparency. These efforts highlight an important problem: Despite years of fighting for equal pay, women in the United States still earn less than men, on average, for equal work.
Unfortunately, the issue persists in healthcare. Even though women make up about 70 percent of the healthcare workforce, their earnings trail men’s. One report on the gender pay gap in healthcare notes that women physicians make about 26 percent less than men physicians. This chasm persists even when accounting for ethnicity, location, years of experience, and specialty.
We asked the participants in our 2024 Women in Medicine study whether they’d ever negotiated their salary and why. Only about half of respondents said they had asked for higher pay. For 35 percent of women, employer policies presented a barrier to negotiating opportunities.
Employer Policies That Contribute to the Gender Wage Gap
The reasons for the gender pay gap in medicine are multidimensional. For example, some experts posit that women are less likely to negotiate their salary. However, others note that women’s assertiveness during negotiations is simply not as well received as men’s.
Some organizational policies around pay raises can also contribute to these disparities, including:
Pay Scales Based on Years of Experience
Women are likelier than men to step away from the workforce to prioritize caring for children. This resume gap means these women have fewer years of experience, which can hurt them during salary negotiations.
Many organizations factor years of experience into their pay scales. While this practice may be difficult to change entirely, employers should strive to implement policies where experience is not the only factor. Instead, they can weigh years of experience along with:
- Education and advanced degrees
- History of accomplishment in the workplace
- Specialized skills and certifications
Salary Models That Rely on Past Pay
Several states and cities have passed laws prohibiting employers from inquiring about past pay during job interviews. However, the practice isn’t consistent across the country.
Because women tend to earn less than men overall, asking them about their pay history can perpetuate the wage gap. It can also force women to begin negotiations at a lower level than men.
This problem is compounded by the reality that women tend to be less successful in negotiations altogether. Some companies have aimed to remedy this issue by publishing salary ranges for all roles, which helps level the playing field.
Policies that Discourage Salary Transparency
Forbidding salary conversations between employees, also known as pay secrecy, is illegal under the National Labor Relations Act. Still, some health systems discourage these discussions, leaving workers hesitant or fearful of sharing wage information.
However, women who don’t know they’re being paid less don’t have the opportunity to speak up or negotiate. To combat this issue, several states and companies have adopted the practice of publishing salary information.
Closing the Gender Pay Gap in Medicine
Closing the gender wage gap in healthcare requires a multipronged approach. Implementing policies that reform and equalize pay scales is one strategy that has profound effects. When employers prioritize reducing pay inequities, they’re more likely to recruit and retain exceptional women healthcare workers in the long term.
