Salary negotiations: Advice for female physicians who want equitable pay

There are more women in medicine than ever before, but in study after study, female physicians still earn less—sometimes a lot less—than their male counterparts.

One way women can begin to close that gender pay gap is by developing better negotiating skills, says Rebecca Parker, M.D., a practicing emergency room physician in the Chicago area who has fought for gender equality in healthcare throughout her career.

Photo of woman doctor
Rebecca Parker, M.D.
(Envision Healthcare)

Negotiating is a skill women doctors need to learn and practice, Parker, chief medical affairs officer for Envision Physician Services and former president of the American College of Emergency Physicians (ACEP), said in an interview with FierceHealthcare.

“How you negotiate as a woman is important,” says Parker, and female doctors need to be prepared to negotiate to get the best deal possible.

However, a recent study of general surgery residents found that women anticipated an ideal starting salary that was $30,000 less than their male counterparts and also had less confidence about salary negotiations. Female residents were far less likely to believe they had the tools to negotiate successfully, 18.6%, versus 31.7% of men.

That lack of negotiating skills can be very costly. Over a 30-year career, it amounted to a $900,000 potential difference in lost wages over a lifetime, researchers found. That first salary negotiation can impact earning potential for the rest of a physician’s career, agrees Parker.

RELATED: In Maryland, female doctors’ salaries about 50% less than male colleagues'

That’s why Parker says she tries to share the lessons she’s learned over the years in her own medical career. To help mark September's Women in Medicine Month, we asked Parker to share some tips:

Know the market. Before you start negotiating, be prepared, she says. Know what the other people around you are making so you know what you want to ask for. For instance, if you are applying for an assistant professorship, know what the position pays across the country and in your area.

Research the salary ranges for the location and position you are seeking. The Association of American Medical Colleges publishes salary information based on academic appointments. Companies such as Merritt Hawkins and others regularly survey physicians and report salary data. It’s also acceptable to ask colleagues about their base salary and benefits, she says.

A 2018 study in Maryland found female doctors made a startling 50% less than male colleagues. The bottom line is women need to ask for what their work is actually worth.

Tailor your approach to get the best outcome. Research shows women do better when they take a different approach then men, whether the person they are negotiating with is a man or a woman, Parker says. Women tend to do better and are perceived in a positive light when they focus on the greater good and use comparative data. "Versus the whole classic ‘I did this, I deserve a raise, I, I, I,'” she says.

While men do well when they speak directly about their competency, studies show women have more success when they talk about how their attributes can help the organization. While it may be a bias, “we do better when we couch it in other terms. This has been a more effective technique,” she says. The Clayman Institute for Gender Research is a good resource for research on gender inequality, she says.

RELATED: 3 ways doctors say can help break the 'fiberglass ceiling' and close the startling gender pay gap

Don’t be afraid to just go for it. Men are just better at going after jobs they are interested in. Maybe they have only 60% of the qualifications listed in a job description, but they are more apt to say, ‘I’m going to go for it,' Parker says. Women tend to believe they must meet every single qualification to get a higher position or that they need, for instance, to get an advanced degree before applying.

They may not be 100% qualified, but men will think they can learn the rest on the job. I always quote my mom. She used to say to me if I was nervous about applying, ‘you definitely won’t get that university, that scholarship, that job if you don’t apply.’ You’ve got to apply if you are going to get it, Parker says.

You have to be able to network. Reach out to leaders at your organization. A senior leader can walk you through it and tell you how they did it. Recognize the difference between mentors versus champions. A mentor is someone you go to for advice and can bounce ideas off of, Parker says. A champion is someone who not only brainstorms with you but pulls you up and pulls you through the process. A champion will tell you to apply for a job or promotion and offer to write a letter of recommendation, says Parker, who has established a champion pilot program at Envision, a multispecialty physician group and healthcare services team that includes 100 leaders who have volunteered to help champion others.

RELATED: Pay gap widens for women physicians; earnings average $105K less than men

A champion will introduce you to other people. They can recommend you for a committee or team. It’s a great way to bring along the next generation, says Parker. 

Parker, who is 49 and graduated from Northwestern University's medical school in 1995, says when she started in medicine there were not a lot of women in the upper tiers of the medical hierarchy, but that is changing. “We are each advancing on each other’s shoulders,” she says.

“I do think things are much better than from when I started,” she said. At that point, women were no longer having to fight to prove that they belonged in the profession or were smart enough and could do the work. “Nobody questioned me being there,” she said.

RELATED: Study—Women make up only 30% of healthcare executives. Here's a look at why

Parker got married in medical school and has two sons, who are 11 and nine. When her youngest was five, her husband was taking him to preschool one day when her son announced that he wanted to be a mommy when he grew up. Her husband asked him why. “Only mommies are doctors,” he said. But now he knows both women and men can become doctors, she says.

Female doctors of her generation have tried to make progress when it comes to the pay gap and fighting for time off for both men and women to care for a new baby or a sick family member. While the attitude was once disbelief if a doctor said she wanted to take a couple of months off to care for a newborn child, organizations now are willing to make accommodations.

When Parker ran for ACEP president, she made diversity and inclusion cornerstones of her platform. As the group's president, she convened a summit and a task force on diversity and inclusion and achieved measurable results. For example, as a result of her efforts, women were elected to one-third of the voting seats on ACEP’s board of directors, the organization’s all-time high. She also increased the number of female speakers at national meetings from 20% to 40%.

And at Envision, she has established a recruiting pipeline for female physicians and is pioneering that champion program that pairs young women physicians with more experienced colleagues to provide more leadership training and opportunities. She is also currently spearheading the Lean In project founded by Facebook chief operating officer Sheryl Sandberg to help women achieve their ambitions.

To date, she has partnered with Envision’s human resources department and started to develop an infrastructure to provide tools that help women in medicine navigate and overcome common challenges, focusing on issues such as unconscious bias and also negotiation techniques.