Don’t Go There, Paula

You may remember my blog entitled  Gender Pay Gap for Doctors.   You may remember that I questioned the validity of a researcher doing research on her own colleague’s pay.   You may also remember that I felt that this issue has nothing to do with the doctors who actually PRACTICE medicine. Regular physicians bill for what they do. This is usually in increments of relative value units. We have to use very special coding system to send to the insurers to get paid for our services. Any differences that male and female doctors get paid is due to them billing less because they did less work. End of story. Well,  Dr. Pauline Chen of the New York Times decided to fall prey to this issue and took it hook, line and sinker:

This was not the first time I had heard a colleague speculate on how her sex might affect the way others treated her professionally, but we all thought medicine was one of the few careers in which men and women working the same hours and producing comparable results in similar specialties would be paid and promoted equally.

It does.  Show me the proof that a physician working on a productivity model is paid less UNFAIRLY!  You can’t.


Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  5 comments for “Don’t Go There, Paula

  1. big picture doc
    July 21, 2012 at 6:54 pm

    Here’s a true story.
    I worked for an HMO. [Yes, that was stupid]
    I was booked with all the patients with chronic illnesses who brought in shopping bags full of pills to be sorted through. I spent lots of time going through their histories, stopped their redundant medications, and got them healthier, thus saving the company tons of money.
    My male colleagues scheduled were filled with patients with sore throats. They did not have to spend hours going over abnormal lab reports, and calling patients back etc and thus they could see 50 patients a day and were considered “more productive” than me.
    The straw that broke the camel’s back was when I was asked to blindly sign for prescription refills for other providers without access to the charts. My patients would frequently ask me why there was such a high turnover rate for the female physicians in this company. In retrospect, I should have told them how these bastards operated the company.

  2. Bridget Reidy
    July 18, 2012 at 5:00 pm

    But women physicians are no different than other women in that they cannot be assertive without being called “bitchy”. If I tell a receptionist that a yearly CBC has no medical benefit or that I would like hours a person can be reached along with a phone number I am given no respect. Have to spend more time explaining to a patient why I am not doing what the “nurse” said I would do, and I spend 10 minutes reviewing a EMR (not designed as paper charts are, to be read by providers) so I can sound intelligent when I call a patient about thier lipids and they’re never at that number at that hour and I’m going to take just as long the next time I try. And you know all those patients who live women doctors, they and alot of people who prefer us but don’t say much like us because they think they’ll get more time, or listening, or sympathy, or raport, or any of those things that are necessary but not included in the E and M guidelines. (I can’t believe the argument against my point of view here, which normally I find quite sensible, actually uses the assumption that E and M codes are an adequate measure of our work!). And patients have a way of getting what they expect. Men who don’t believe me, has it ever occurred to you that your thickly accented colleagues or the ones who cant explain things in lay terminology can get through the same visit faster? patients don’t realize when they give up asking questions of a doctor because they don’t understand them that they are making that doctor richer, but they are. I’m not saying these problems should be fixed. Most of us women enjoy communicating with patients and meeting thier expectations, but sometimes it’s a problem and we would be richer if society valued us in the same way it values men.

  3. Johnnie Testerman
    July 13, 2012 at 4:16 pm

    If a person agrees to take a job making a certain amount then they share responsibility. The option is always there to negotiate for more. If a person feels that they are not getting paid what they are worth then ask for more, or find a new job. I am tired of hearing these arguments. I doubt the employers look at women and say “if you were a man I would offer you 10% more, but you aren’t”. This is not a forced labor situation. If somebody is willing to be hired for less they shouldn’t fuss.

  4. Diana
    July 12, 2012 at 10:57 am

    What about all the physicans in academic settings at medical schools! A huge percentage of physcians practice in this environment. They are paid salaries carry full time clinical duties in additon to their teaching responsibilities. I am an education coordinator, but I have seen the numbers. I began my career at our universityh in HR. The data is indisputable. The number of women faculty is increasing, however, there is still a glass ceiling where women faculty are concerned. Take a look at the ratio of Male/female department chairman and their respective salaries when compared to their colleagues. I am an education coordinator, but I have seen the numbers.

  5. July 12, 2012 at 10:00 am

    Which goes to show, yet again, why women who make a show and cause of their gender cannot be trusted to give a reliable, objective account. As a graduate of The (now-feminized) Citadel, and a former naval aviator, I saw those two organizations and yes, their cultures, gutted by pushy women crusading on an unsupported notion of fairness and entitlement that did away with those very attributes in which they purportedly wished to share.

    Am I a sexist? Certainly not (I’m a chauvinist, which is quite different). In med school 20 years ago, the percentage of females was in the high 40’s (now greater than half) and I both enjoyed working with, and respected my classmates. I had female instuctors throughout residency, some bad, some awesome, and I went into practice with a female partner with whom I had just graduated. To this day we have regarded each other as equals, and yes, there were times when I made more than her – because I worked nights and weekends while she took off extra time with her husband to raise their kids! Neither of us resented the others’ choice, and there were no stupid, baseless murmurings of sexism, inequality, or whatever obligatory narrative is fed out by the N Times for useful pawns like Dr Chen. Her inference is an insult not only to myself, but to every practicing physician of either gender.

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