Imagine a scenario: Two doctors complete training in the same program and go on the interview trail for attending jobs together. They interview for the same position on different days. Both are newly minted attending physicians who met the same requirements for residency completion. The first physician gets offered a compensation package and is considering the position seriously. The second doctor is also offered a compensation package and is considering taking the position.

Unbeknownst to the employer, the two doctors are close friends. They sit down one evening and have a casual discussion about the progress of their job search. During their conversation, it becomes clear that there is an almost $40,000 difference in their offered compensation packages for the same full-time equivalent and job responsibilities. Can you guess the gender of the doctor offered the inferior package?

Pay Transparency Test Cases

Pay transparency is a simple concept that seems to have a substantial positive impact on organizations who implement it. Of course, there is fear associated with revealing this information that prevents many industries and companies to pull the trigger on pay transparency.

John Mackey, CEO of Whole Foods, opened his books and provided his employees with pay transparency for over thirty years and is a trailblazer in this arena. When asked about the effects of this on his company, he admits that at first, he was fearful, but the results spoke volumes. It is all about having the initial conversation and being offered the opportunity to do so.

Sumall, a data analytics company based in NYC that launched in 2011, practices pay transparency. The original cadre of employees was a small number (10 people), but there was complete salary transparency, and as the company grew, retention has been linked to employees feeling encouraged and empowered to discuss any qualms about salary-related concerns with management. During the interview process, CEO Dane Atkinson, says that candidates are taken aback by the pay transparency policy of the company and appreciate the company’s openness.

An open pay policy allows for the conversation about pay that to be based on full disclosure instead of secret deals and bantering. When employees are aware of what their colleagues are making that have the same jobs and note equity, performance and morale thrive.

Why Not Medicine?

Pay transparency in several different industries from the tech to the food industry has a track record. If it works in these areas, why wouldn’t it work in medicine? The larger question is how the implementation would occur?

Salary polls are a representation of pay transparency. Doximity has a career navigator as a part of its platform that allows for the average salaries by specialty and location to be sourced. Doximity has a robust tool that can provide a framework for job candidates to use in negotiating starting salaries. The values listed on this interactive map, are averages so the next iteration in transparency would be for the actual group or practice to have a reference for their compensation packages.

There is sometimes a tricky line of questioning that can lead to the exacerbation of the gender pay gap during job interviews. When employers ask about payment history, they are inadvertently perpetuating the presence of a previous discrepancy.

For example, if the previous job was paying at a level that was already less than male counterparts (who may have negotiated for a higher starting salary upon entry) then using that data as a basis for current offerings does not correct for the fundamental difference.

Several states are on board with the pay transparency and salary history ban that is picking up traction and could serve to help close the gender pay gap. One such state is Hawaii, who plans to implement this policy starting in January 2019. The law supports this solution to closing the gender pay gap.

Until this is a global policy, we women in white coats will need to use the tools that are available about compensation when we are looking for positions, or negotiating contract renewals so that we can do so powerfully and get compensated for our worth.

Perhaps if there was transparency in the organization the two resident doctors mentioned previously were applying to, there could have been a very different conversation had over coffee. Until the halcyon of total salary transparency becomes our reality, we women in white coats will need to be forearmed in our contract negotiations to do our part in level the playing field.

Dr. Charmaine Gregory is a night shift Emergency Physician practicing full-time at St Joseph Mercy Hospital Ann Arbor, MI. She is a co-author of The Chronicles of Women in White Coats. She is a survivor of physician burnout and has a penchant for fitness and physician wellness.