Special Contractual Issues for Women Physicians
As a physicians’ attorney focusing on physician contract review, I spend all of my professional life reviewing and negotiating physician employment agreements. In my experience, women physicians have several issues that need special attention when negotiating their physician employment agreements.
Any physician needs to be familiar with appropriate compensation, through benchmarking data such as that published by Medical Group Management Association (“MGMA”). However, while this may be one of several critical issues for a male physician, an MGMA compensation analysis is especially important for women physicians.
A recent survey by the physician recruiting firm Merritt Hawkins provides a shocking set of data concerning gender pay discrepancies in Maryland. The Merritt Hawkins survey, based on 2020 tax information, found that the difference in pretax income between male and female physicians in Maryland overall was 49.6%. Primary care female physicians had a pay discrepancy of 41.2% while female physicians in surgical, diagnostic and other specialists had a pay discrepancy of 33.5%. Male physicians in Maryland who were in private practice made 30.9% more than female physicians in private practice.
Accordingly, insistence on compensation consistent with benchmarks is obviously of critical importance for female physicians. An employer must explain the discrepancy if the salary, physician sign-on bonus, relocation allowance, or other compensation offered is less than the relevant benchmark.
Female physicians must also walk a fine line when asked questions that are illegal. Male physicians are almost never asked if they intend to have a family. Although male physicians are frequently asked if they are married (another illegal question), marriage is rarely viewed as a negative for a male physician. After all, the male physician may take a day or two off for the birth of a child. For a female physician, however, the birth of a child will have a much bigger impact.
Ascertaining the culture of a new employer is another factor that is important to male physicians, but absolutely vital to female physicians. Rating sites such as Rate Your Healthcare Employer can help you avoid a miserable working environment. I am currently representing a female physician who is interested in renegotiating her contract. I sent a letter discussing all of the contractual issues to the employer’s legal counsel. A few days later my client was accosted in the hall by her supervisor, who said they needed to talk about my letter. Notwithstanding her protests that her lawyer should be involved, her supervisor insisted that “this will only take a minute,” and that the two physicians should discuss the situation.
The meeting drug on for over an hour, and my client became increasingly upset by the way she was being treated by her supervisor. At one point the supervisor asked her why she was so “sensitive” and “emotional.” Presumably, a male physician would not be expected to become upset when discussing a little detail such as his career, no matter how much disrespect he may be shown.
Another issue that is important to all physicians, but can assume enormous importance for a female physician in particular, is the physician disability provisions in employment agreements. Although federal law requires the employer to treat pregnancy like any other disability, many employers (hopefully unknowingly) violate this law. Some employers have specific maternity leave provisions. If a female physician thinks it is at least possible that she may wish to have a child in the future, these provisions should be carefully examined. Although I am obviously biased, I think having your attorney inquire as to these provisions in the context of many other questions might reduce the possibility of setting off alarms for the employer.
All physicians need to be concerned about issues such as starting work under a physician employment agreement, physician covenants not to compete, call coverage requirements, potential ownership in a private practice, malpractice insurance in physician employment agreements, physician benefits, etc. Unfortunately, until discrimination against female physicians ends, female physicians need to be especially vigilant in protecting their rights.