Gender differences in Physician Assistant productivity in three specialties
Halsey, Kirsten Ueland
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BACKGROUND: The gender wage gap has existed since women started entering the workforce. Once large, the wage gap narrowed significantly in the 1980’s, and plateaued in the 2000s. Proposed rationales for the wage gap include: gender differences in negotiation, unconscious bias or discrimination, and productivity differences between men and women. Productivity is commonly measured in terms of relative value unit (RVU) generation. RVU assignment to non-clinician providers (NPCs) such as PAs and NPs is inaccurate, contributing to a lack of data regarding their productivity. Little is known about PA productivity in general, particularly gender differences. The purpose of this study is to formulate a standardized definition of clinical productivity and to compare mean productivity of male and female PAs in three specialties. LITERATURE REVIEW FINDINGS: Women are assumed to be poorer negotiators. However, when negotiation, a stereotypically “male” act, is framed in a communal way, gender differences vanish and women are as equally successful. Unconscious bias and discrimination against women have detrimental effects on their salary, job satisfaction, and psychological health. The assumption that women are less productive than their male counterparts arises from the belief that women will drop work obligations to care for the family. After controlling for practice, personal, and productivity differences, women continue to earn significantly less than their male counterparts. The persistent, unexplained wage gap suggests that uncontrolled variables, such as bias or discrimination, are the true cause of the wage gap. PROPOSED PROJECT: The proposed project is retrospective cohort study and secondary database analysis obtained from the NCCPA PA Professional Profile. The data will be utilized to determine average, individual productivity for male and female PAs practicing in three specialties. The mean productivity of male and females will be compared using ANOVA. Confounding variables will be analyzed using a multiple linear regression analysis. CONCLUSIONS: Social constructs regarding gender contribute to stereotypes influencing the definition a “successful negotiator” and provide the foundation for bias and discrimination. Clinical productivity cannot be altered by these stereotypes. If no gender differences in productivity exist, this proposed cause can no longer be used to justify the wage gap. SIGNIFICANCE: Accurately measuring PA productivity has several implications including proper compensation, determination of PA impact on practice efficiency, and comparison of productivity between PAs by gender and specialty type, aiding in the search for the true cause of the gender wage gap in the PA profession.