Advancing Education, Research, and Quality of Care for the Head and Neck oncology patient.
Introduction: Despite major advancements for women within medicine, there remains substantial disparities in otolaryngology. Only 19% of registered otolaryngologists are female with similar levels of representation in the head and neck subspecialty. In academic settings, women surgeons are less likely to be first or last-author on manuscripts, hold leadership positions, or be recipients of awards/grants. Another important aspect of characterizing gender disparities within academic medicine is the similarity of financial compensation between male and female physicians. As such, this study seeks to assess the differences in financial compensation between male and female academic head and neck surgeons.
Methods: Twelve states with publicly available salary data were identified, and otolaryngology salary data was extracted from associated academic institutions, with further analysis focusing on head and neck surgeons. Physician characteristics including gender, faculty rank, years since medical school, subspecialty, number of publications as first or last author, number of registered clinical trials, and number of NIH grants were extracted using Doximity. Individual Medicare billing information was also collected to account for differences in clinical effort (part- vs full-time work). Univariable and multivariable linear regression models were performed to evaluate associations between gender and inflation adjusted salary before and after adjusting for physician characteristics.
Results: Data for 77 academic head and neck surgeons was collected with 19 (24.7%) female and 58 male (75.3%). The median salary for females was $381,375.70 and $445,842.20 for males (p=0.77). Median years since medical school was significantly fewer for females than males (13 vs 21 years, respectively, p=0.031). Most men were full professors (44.8%) while most women were assistant professors (47.4%). Median number of publications as first or last author for female and male surgeons was 17 and 24 respectively.
In the univariable linear regression setting, there was no significant difference in salary based on gender, with male surgeons making on average, $3,500 more than female surgeons (p>0.9). Years since medical school, faculty rank, number of registered clinical trials, number of registered NIH grants, number of publications as first or last author, and Medicare payment were all significantly associated with salary (p<0.05). Notably, the average expected salary for full professors was $295,000 more than assistant professors. After adjusting for physician characteristics as additive effects, faculty rank (p = 0.039) and number of NIH grants (p = 0.03) remained significantly associated with salary.
Conclusion: Following comprehensive assessment of physician characteristics, no significant difference in salary based on gender was observed for head and neck subspecialty whereas faculty rank was significantly associated with salary differences. However, to further mitigate gender disparities, future studies should examine female representation and barriers towards faculty rank advancement.