Determinants of Salary Variation and the Gender Pay Gap: A Survey of the American Association of Hip and Knee Surgeons (AAHKS) Surgeon Member Workforce

IF 1.5 Q3 ORTHOPEDICS

Arthroplasty Today Pub Date : 2024-11-07 DOI:10.1016/j.artd.2024.101554

Prem N. Ramkumar MD, MBA , Jenna A. Bernstein MD , David C. Landy MD, PhD , David E. DeMik MD , Justin T. Deen MD , Reena J. Olsen MS , Anna Cohen-Rosenblum MD

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引用次数: 0

Abstract

Background

The increased emphasis on reimbursement, diversity, and burnout in hip and knee arthroplasty necessitates a foundational understanding of the surgeon workforce. The purpose of the study was to cross sectionally survey a representative sample of the AAHKS surgeon membership on the subject of salary, practice patterns, and demographic factors to establish a baseline framework for future advocacy efforts and initiatives.

Methods

An online survey was sent to AAHKS members between December 20, 2022 and January 19, 2023. Surgeon demographic data, experience, practice geography and type, and annual case volume were solicited. Univariate and multivariate analyses were performed to describe the association of respondent characteristics with reported salary directly from patient care, as well as indirect revenue streams.

Results

A total of 730 AAHKS members responded to the survey. The largest proportion of surgeons performed 251-400 cases annually (36%); 81% (n = 592) and 93% (n = 679) of respondents identified as white and male, respectively. Case volume was the primary determinant for surgeon salary, followed by practice type, years in practice, and gender. After controlling for confounding variables, multivariate analyses revealed the direct salary of women surgeons was 14.4% less than men [95% confidence interval, 0.4%-28.3%]. When considering indirect revenue, the gender pay gap widened. Salary was not associated with reported hours worked per week, geographic location, or ethnicity.

Conclusions

Salary is an important but underdiscussed subject that reflects the realities of our culture and value system in medicine. A direct relationship between salary and modifiable variables like case volume is clear. However, after controlling for confounders, women arthroplasty surgeons still earn 86 cents on the dollar compared to their male colleagues from direct surgical revenue.

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薪酬差异和性别薪酬差距的决定因素：对美国髋关节和膝关节外科医生协会（AAHKS）外科医生成员队伍的调查

背景髋关节和膝关节置换术中的报销、多样性和职业倦怠问题日益受到重视，因此有必要对外科医生队伍进行基本了解。本研究的目的是对AAHKS外科医生成员中具有代表性的样本进行横截面调查，内容涉及薪资、执业模式和人口统计因素，以便为未来的宣传工作和倡议建立基线框架。方法在2022年12月20日至2023年1月19日期间向AAHKS成员发送在线调查。调查内容包括外科医生的人口统计学数据、经验、执业地域和类型以及年病例量。我们进行了单变量和多变量分析，以描述受访者特征与所报告的直接来自患者护理的薪酬以及间接收入流之间的关联。最大比例的外科医生年手术量为 251-400 例（36%）；分别有 81% （n = 592）和 93% （n = 679）的受访者认为自己是白人和男性。病例量是决定外科医生薪酬的主要因素，其次是执业类型、执业年限和性别。在控制了混杂变量后，多变量分析显示女外科医生的直接薪酬比男外科医生低 14.4% [95%置信区间，0.4%-28.3%]。当考虑到间接收入时，性别薪酬差距扩大了。薪资与报告的每周工作时间、地理位置或种族无关。结论薪资是一个重要但讨论不足的话题，它反映了我们的医学文化和价值体系的现实。薪酬与病例量等可修改变量之间的直接关系显而易见。然而，在控制了混杂因素后，女性关节置换外科医生的直接手术收入仍比男性同事少 86 美分。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Arthroplasty Today Medicine-Surgery

CiteScore

2.90

自引率

0.00%

发文量

258

审稿时长

40 weeks

期刊介绍： Arthroplasty Today is a companion journal to the Journal of Arthroplasty. The journal Arthroplasty Today brings together the clinical and scientific foundations for joint replacement of the hip and knee in an open-access, online format. Arthroplasty Today solicits manuscripts of the highest quality from all areas of scientific endeavor that relate to joint replacement or the treatment of its complications, including those dealing with patient outcomes, economic and policy issues, prosthetic design, biomechanics, biomaterials, and biologic response to arthroplasty. The journal focuses on case reports. It is the purpose of Arthroplasty Today to present material to practicing orthopaedic surgeons that will keep them abreast of developments in the field, prove useful in the care of patients, and aid in understanding the scientific foundation of this subspecialty area of joint replacement. The international members of the Editorial Board provide a worldwide perspective for the journal''s area of interest. Their participation ensures that each issue of Arthroplasty Today provides the reader with timely, peer-reviewed articles of the highest quality.