‘Charge what you think you're worth’: a qualitative study exploring the gender pay gap in medicine and the role of price transparency

Background: The gender pay gap in medicine is entrenched and has a negative impact on economic growth, institutional reputation and financial success, recruitment, retention and job satisfaction of female specialists and patient care. It also discourages women from entering specialist fields of medicine. In the Australian unregulated market setting, female specialists are not simply getting paid less, they are choosing to set lower fees than their male counterparts. Aims: We examine how implicit and explicit gender biases affect how fees are set and the potential role of price transparency in addressing the gender pay gap. Methods: We conducted 27 semi-structured interviews with medical specialists recruited via social media and medical society newsletters between June 2021 and March 2022. Interviews were recorded and transcribed verbatim. Data were analysed using thematic analysis. Twenty surgeons and seven anaesthetists, 15 of whom identified as male and 12 as female, participated in this study. The primary outcomes and measures focused on the perspectives of surgeons and anaesthetists regarding fee-setting practices. Results: A combination of contextual and market- and gender-related factors was the source of the biases that determine fee setting. Further, information asymmetry in medicine in Australia underlies current fee-setting practices, exacerbating and entrenching false perceptions about women's skills as surgeons and anaesthetists. Women tend to internalise these biases, self-regulating their behaviours and how they set their fees. Conclusion: The gender pay gap is pervasive. Greater transparency on fees and quality could be explored as a potential solution to reduce pay inequality.