By Lisa Rapaport

(Reuters Health) – Physicians’ employers should commit to gender equity in pay, leadership development, career opportunities, and parental and family leave policies, a leading U.S. doctors group recommends.

Among other things, the recommendations from the American College of Physicians (ACP) urge hospitals, clinics and other places that employ doctors to avoid financial or career penalties for working less than full time. Both men and women should also have the same access to a minimum of six weeks of family and medical leave even when they’re still medical students or physicians in training.

“For many reasons, including the pay gap and gender bias and discrimination, women physicians face a higher rate of burnout than men – some studies show that rate to be as high as 71 percent for women physicians,” said Dr. Susan Thompson Hingle, chair of the ACP Board of Regents and a professor at the Southern Illinois University School of Medicine.

“Burnout is not only due to the pay gap, but it certainly contributes,” Hingle said by email. “Burned out physicians not only leave medicine early, thus worsening the physician shortage, but they also provide lower quality care . . . , have higher rates of medical errors, and lower patient satisfaction.”

To start addressing gender equity issues, parental leave should be mandated even in medical school and there should be flexibility in board certification processes that allow for trainees who take time off for parental leave to still sit for their boards, Hingle said.

“Promotion and academic rank are contributors to salary and to respect,” Hingle added. “Because of many factors, including societal expectations, women progress more slowly through the academic ranks, thus contributing to the gender disparities in salary and in leadership.”

Hospitals, clinics and other employers should also take steps to increase the number of women in leadership positions, the recommendations note. Employers should also investigate the impact of gender compensation inequity and barriers to career advancement and best practices to close these gaps across all practice settings.

Regular training sessions should also cover topics like implicit bias that might get in the way of women receiving equal pay or opportunities for mentoring, training and advancement on the job.

In addition, employers should offer programs in leadership development, negotiation and career development to medical students and junior physicians.

“Gender and status are so tightly conflated (men and things associated with men like leadership, power, authority are imbued with higher status than women and things like nurturing, supporting, relational) that it allows subjectivity to unintentionally influence the way the human mind evaluates objective data,” said Dr. Molly Carnes, author of an accompanying editorial and director of the Center for Women’s Health Research at the University of Wisconsin-Madison.

“So a high salary ‘for a woman’ brings to mind a different dollar amount that a high salary ‘for a man,’ and this leads to salary discrepancies across all fields,” Carnes said by email. “Every field has its own metrics for calculating salary, but the same phenomenon leads to the gender pay gaps in all fields.”

SOURCE: Annals of Internal Medicine, online April 16, 2018.