Female plastic surgeons earn much less than their male counterparts, and the reasons are more complex than you might think.
A new study from the US has provided fresh evidence into the cause of the gender wage gap in plastic surgical practice.
Female surgeons conduct fewer procedures overall and fewer major surgeries. They also bill and code the procedures they undertake differently than male surgeons.
Researchers from Brown University looked at surgical cases submitted to the American Board of Plastic Surgeons by 1,036 candidate surgeons between 2014 to 2018 (277 were women) focusing on the how female and male surgeons coded the procedures they conducted for billing purposes.
In general surgery procedures, clinical coding involves assigning standardised medical codes for billing purposes.
Surgeons used the relative value unit (RVU) to determine the codes. The RVU is a standardised measure of value in physician services to account for factors affecting the value of a physicians’ work, including time, effort, and risks of specific procedures and services.
Each surgical procedure — or section of a complex procedure, has a unique RVU assigned. Surgeons can negotiate their rate for each RVU.
The total average RVUs for female surgeons was almost 20 per cent lower than men. Female surgeons had 11 per cent lower RVUs billed per surgery conducted, compared to men. Female plastic surgeons also performed 14 per cent fewer major surgeries compared to men.
Income disparities between female and male plastic surgeons can also be attributed to differences in work type: female surgeons are likelier to work in academic or independent academic settings, while male surgeons are more likely to work in private practice.
Across academic, independent, and private practice settings, male surgeons billed more work RVUs than female surgeons. According to the study, similar trends in coding practises exist in cardiology.
“It is not simply the volume of surgery that affects annual income but the types of cases performed,” the researchers noted.
“This study should encourage acknowledgement of gender disparities in surgical practice types, as well as in billing and coding practices.”
“It supports the hypothesis that differences in earnings between male and female plastic surgeons are related to the number of major operative cases performed and how they are coded.”
Several studies have revealed the widening gender pay gap in medical specialties including plastic surgery.
One recent survey found an 11 per cent income gap for women in plastic surgery: a $49,000 disparity in their annual income.
Researchers from Brown University concluded that more initiatives must be implemented to improve coding practices among plastic surgeons. They also want to see more studies devoted to understanding the gender-related differences in billing and medical coding for surgeries.
“It is important to code accurately, not only for oneself, but for appropriate reimbursement and documentation of patient illness severity for the medical system to ensure that reimbursement is dispersed equitably,” they concluded.