The gender pay gap isn’t new, but negotiating what’s important can help


April 08, 2022

4 minute read


Disclosures: Chagpar reports support from the AMA’s Joan Giambalvo Award for the Advancement of Women.


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Significant gender disparities exist in pay, promotion and benefits in all fields (not just medicine), and have done so for centuries.

It’s unfair and it’s not fair, but unfortunately, this knowledge alone is not enough to change the status quo. The simple act of pointing out the disparities is very analogous to the experiment in which capuchin monkeys who, seeing their counterparts get grapes (the preferred payment for performing a task), throw the less favored cucumber to the investigators and shake their cages. We can speak out against inequality, but what we really need is a strategy to act on.


"In order to recognize the diversity within each gender... it behooves us to know how to negotiate effectively without being seen as overly demanding, greedy, belligerent or worse." - Anees B. Chagpar, MD, MSc, MPH, MA, MBA, FRCS(C), FACS



So how do we do this? Some have argued for greater transparency as a way to correct the disparities. Certainly, some have found that transparent and structured compensation plans can reduce (but not eliminate) wage disparities. Others, however, have found that transparency alone does not alleviate inequalities and can, in fact, exacerbate feelings of discrimination that exist in the workplace.

And, as the COVID-19 pandemic has taught us, it’s not all about the money. A recent report in the harvard business review noted that more female physicians are considering either reducing their clinical practice or leaving the workforce altogether. Sure, pay inequality has something to do with it, but it’s also a reflection of some employers’ lack of flexibility around maternity leave, child and elder care, and the myriad of other things that leave women feeling (to a greater extent than men) exhausted and undervalued.

While it can be helpful to have programs that provide paid time off, on-site childcare facilities, and flexibility in childcare schedules, it is important to realize that these efforts will be more important for some women than for others. ‘others. Indeed, there may not be a “one size fits all” approach to ensuring women feel valued in the workplace.

What might be more effective – both in reducing pay inequality and ensuring that women feel valued – is for women to simply negotiate for what is important to them. It’s well known that “women don’t ask” and that we tend not to plead as strongly or as well for ourselves as we do for others. As such, some have advocated negotiation training as a way to help reduce the inequalities that exist. I know what you’re thinking: one more thing, as if women don’t have enough on their plate! And why should the responsibility lie with women? These are fair points; however, to recognize the diversity within each gender, and the individual values ​​of each, it behooves us to know how to negotiate effectively without being seen as too demanding, greedy, belligerent or worse.

Many institutions and professional groups, including the Association of American Colleges, have included negotiation training in their leadership workshops, especially for women. I have taught many of them over the past decade. They are generally universally well-received as fun, energizing and motivating, but one wonders if they really have an impact. During the pandemic, when in-person workshops ceased to exist, the American Medical Association called for nominations for the Joan Giambalvo Award for the Advancement of Women. I was honored to receive this award and set out to not only create a virtual trading workshop, but also test its effectiveness. To my surprise, our virtual negotiation training workshop not only improved knowledge and confidence in negotiation skills, but also improved results! The women affirmed their knowledge and confidence in negotiation following the workshop and, 3 months later, 40.7% of the respondents declared that they had used what they had learned: 57.7% had negotiated for a salary, 41.7% for a promotion and 32% for a job. – related benefits. These negotiations went “better than expected” in 26.6%, 30% and 37.5% of cases respectively. Before the course, only three (2.9%) felt that their last negotiation had gone “very well” or better; 3 months after the course, 28% felt that their last trade after the course went “very well” or “extremely well” (P = .002). Getting such statistically significant results with a relatively small sample blew my mind!

To be clear, closing the gender gap will take a multi-pronged approach, and I have no illusions that it will be easy or quick. But knowing that we can start turning the wheel by honing some basic negotiation skills gives me optimism for the future.

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Anees B. Chagpar, MD, MSc, MPH, MA, MBA, FRCS(C), FACS, is a professor in the department of surgery at Yale University School of Medicine and a board member of the Women in Oncology Peer Perspective at Healio. She can be contacted at [email protected]

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