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In Pediatrics, Women Face Unique Mistreatment and Disparities

— Studies report more sexual harassment, smaller salaries, worse patient ratings

MedpageToday

ANAHEIM, Calif. -- Female pediatricians and pediatric post-graduate students in the U.S. face unique mistreatment and disparities, according to three abstracts presented here at the annual meeting of the .

Nearly 10% of surveyed pediatric emergency medicine fellows -- more often women -- reported that they'd been sexually harassed during their fellowships; another study revealed that female pediatric faculty make less money than men; and a patient-rating analysis found that female pediatric surgeons received lower ratings, possibly due to "implicit gender biases."

Sexual Harassment

Nine percent of 140 pediatric emergency medicine fellows -- and 17% of cisgender women -- said they'd experienced sexual transgressions (inappropriate touching) or impropriety (gestures and expressions) during their fellowships, reported Annabel Cramer, MD, of the University of Texas at Austin/Dell Medical School, and colleagues. Perpetrators were mainly men (93% of all recorded events), the survey found.

"This pilot study suggests that sexual harassment is still prevalent at a fellowship level," the researchers wrote in their poster.

The researchers sent out the survey in 2021 and received responses from 26% of 2019-2021 pediatric emergency medicine fellows (140 of 546). The median age was 32 years, 69% were cisgender female, 84% were heterosexual, 77% were white, and 18% were Asian. Most fellowships were in the South (40%) or Northeast (30%).

Only 13% of 104 individuals who responded to a section of the survey on resource availability said they would report sexual harassment to their program or hospital.

Academic Salaries

Salary data for 26,548 pediatric faculty revealed that men "consistently had higher median salaries among all ranks and race/ethnicities," and women were only overrepresented in the lowest academic ranks (instructors and assistant professors), according to researchers led by Kimberly Montez, MD, MPH, of Wake Forest University School of Medicine in Winston-Salem, North Carolina.

The analysis was based on 2020-2021 salary compensation data from the Association of American Medical Colleges annual Medical School Faculty Salary Survey, which represents 152 medical schools (response rate 98%). Of the faculty included, 58% were women, two-thirds were white, 5% were Hispanic, and 4% were Black. Half were assistant professors, one-fourth associate professors, and 17% were professors. Median salary was $216,289.

Men were overrepresented among professors, associate professors, chiefs, and chairs, and "white faculty attained associate professor, professor, chief, and chair at higher percentages than their overall prevalence," the researchers found.

"Our results demonstrated broad disparities in compensation by both gender and race/ethnicity," they wrote. "Additionally, an intersectionality between race, ethnicity, and gender existed. Academic medical centers must identify, acknowledge, and address inequities in compensation models, including conducting transparent salary audits, standardizing new hire compensation benchmarks, and automatic review of salary outliers."

Patient Ratings

For the analysis on patient ratings, male pediatric surgeons were found to score a bit better than females while there was no notable difference in scores between male and female pediatricians who are not surgeons.

"Significant differences in star scores between male and female surgeons may show that implicit gender biases play a larger role in how patients review and perceive surgeons compared to non-surgeons," wrote medical student Liam Butler of Icahn School of Medicine at Mount Sinai in New York City, and colleagues.

Researchers analyzed patient ratings of 913 pediatric surgeons (21% women, 4,282 reviews) and 1,860 non-surgeons (54% women, 5,619 reviews). Female pediatric surgeons had a mean star score of 4.05 versus 4.18 for males (P<0.01), while female non-surgeons had mean scores of 4.11 versus 4.15 for males (P=0.47).

They noted that regardless of the cohort (surgeon or non-surgeon), the younger physicians had higher sentiment and star scores.

"For both groups, reviews that mentioned physician attributes such as 'comfortable' were more likely to be positive, while 'rude' and 'unprofessional' decreased these odds," the researchers reported. "Additionally, while 'confident' increased the odds of positive reviews solely for surgeons, 'kind' and 'warm' only increased odds for non-surgeons."

  • author['full_name']

    Randy Dotinga is a freelance medical and science journalist based in San Diego.

Disclosures

The researchers for the sexual harassment study reported no financial relationships. Disclosures for the salary and star ratings studies were not provided.

Primary Source

American Academy of Pediatrics

Cramer AP "Sexual harassment: A survey on prevalence and frequency amongst pediatric emergency medicine fellowship trainee" AAP 2022; Abstract PC1026.

Secondary Source

American Academy of Pediatrics

Montez K "Examining pediatric faculty compensation by race, ethnicity and gender, 2020-2021" AAP 2022; Abstract PM2079.

Additional Source

American Academy of Pediatrics

Butler L "What leads to a 5-star rating? A sentiment analysis comparing online reviews of surgical versus non-surgical pediatricians" AAP 2022, Abstract O2011.