Report on Gender Pay Disparity Among Physician Associates and Implications for Sustainable Development Goals

Introduction

An analysis of the 2024 Statistical Profile of Board-Certified PAs by Specialty, published by the National Commission on Certification of Physician Assistants (NCCPA), reveals a significant gender-based pay gap. This report examines these findings through the framework of the United Nations Sustainable Development Goals (SDGs), highlighting critical challenges to achieving SDG 5 (Gender Equality), SDG 8 (Decent Work and Economic Growth), and SDG 10 (Reduced Inequalities). The data, derived from a survey of over 100,000 Physician Associates (PAs), indicates systemic economic inequity within a profession where women constitute nearly two-thirds of the workforce.

Key Findings: A Challenge to SDG 5 (Gender Equality)

Statistical Evidence of Economic Disparity

The NCCPA report quantifies a persistent wage gap that directly contravenes the objectives of SDG 5, which aims to achieve gender equality and empower all women and girls. The core findings demonstrate a failure to provide women with equal rights to economic resources.

• Male PAs earn, on average, $20,892 more annually than their female counterparts when working 40 hours or more per week.
• This pay gap persists across all medical specialties, with no exceptions.
• The disparity ranges from a minimum of $10,361 in neurology to a maximum of $34,069 in obstetrics-gynecology.
• This phenomenon, described as a “glass elevator” for men, is observed even in female-dominated professions, undermining progress toward economic equality.

Systemic Inequity and Workforce Morale

The documented pay gap is a systemic issue that threatens the morale and retention of the predominantly female PA workforce. This inequity acts as a significant barrier to the full and effective participation of women in the economic life of the healthcare sector, a key target of SDG 5. The frustration expressed by female PAs indicates that this disparity is a recognized obstacle to professional satisfaction and long-term career sustainability.

Implications for SDG 8 (Decent Work) and SDG 10 (Reduced Inequalities)

Violation of Equal Pay for Work of Equal Value

The findings represent a clear violation of SDG Target 8.5, which calls for equal pay for work of equal value by 2030. The persistence of this gap, even when controlling for variables such as specialty, education, geographic region, and hours worked, points to deep-seated inequalities that SDG 10 seeks to eliminate.

Analysis of Contributing Factors

Several factors are proposed to explain the wage gap, each reflecting broader societal inequalities that hinder the achievement of decent work for all.

1. Career Interruptions: Women are more likely to take time off for family responsibilities, which can negatively impact their long-term earnings trajectory. This aligns with broader gender inequalities in unpaid care work.
2. Specialty Selection: Data suggests male PAs may, on average, select higher-paying specialties, contributing to the overall gap.
3. Inherent Bias: A significant pay gap remains even after accounting for influential variables and is present from the point of entry into the workforce, suggesting systemic bias in compensation structures.

Recommendations for Progress Toward SDG Targets

Employer and Institutional Reforms

Addressing this disparity requires proactive measures from employers and institutions to create equitable work environments, in line with the principles of SDG 5 and SDG 8.

• Pay Transparency: Employers should adopt transparent policies regarding salary calculations and publish salary data to allow for peer comparison and accountability.
• Equitable Compensation Practices: Organizations must ensure that experience, work history, and performance are credited equitably between genders during hiring and promotion.

Empowerment and Negotiation Strategies

While systemic change is paramount, empowering individuals can also contribute to closing the gap. These strategies support the economic empowerment central to SDG 5.

• Data-Informed Negotiation: PAs are encouraged to use official salary data from sources like the NCCPA and AAPA to negotiate fair compensation and challenge inadequate offers.
• Mentorship and Training: Providing negotiation training and mentorship, beginning at the graduate school level, can equip female PAs with the skills to advocate for equitable pay. It is noted, however, that research indicates women often negotiate as much as men but with less successful outcomes, reinforcing the need for systemic employer-side reforms.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article primarily addresses issues related to gender inequality in the workplace, specifically focusing on the pay gap in the physician associate (PA) profession. The following Sustainable Development Goals (SDGs) are directly connected to this central theme:

• SDG 5: Gender Equality
  
  This goal is central to the article, which details the “significant gender pay gap” in a profession that is “nearly two-thirds female.” The entire discussion revolves around the economic disparity between male and female PAs, a core issue of gender inequality. The article highlights this as a “systemic inequity” that needs to be addressed.
• SDG 8: Decent Work and Economic Growth
  
  This SDG is relevant because the article discusses fair and equitable compensation for work. The existence of a pay gap where men earn significantly more than women for comparable work undermines the principle of “decent work for all” and “equal pay for work of equal value.” The article notes this inequity “threatens retention and morale for PAs,” which are key components of a decent work environment.
• SDG 10: Reduced Inequalities
  
  The article’s focus on the income disparity between men and women directly relates to reducing inequalities. The gender pay gap is a clear example of an economic inequality based on sex. The article states that even after controlling for variables like specialty, hours worked, and education, “there was still a significant pay gap,” pointing to a systemic inequality that this SDG aims to eliminate.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the issues discussed, several specific SDG targets can be identified:

• Target 8.5: By 2030, achieve full and productive employment and decent work for all women and men… and equal pay for work of equal value.
  
  This is the most directly relevant target. The article’s core finding is the violation of this principle, stating that “male PAs, on average, earn more than $20,000 more than their female counterparts.” The entire article is an examination of the failure to achieve “equal pay for work of equal value” within the PA profession.
• Target 5.1: End all forms of discrimination against all women and girls everywhere.
  
  The persistent and systemic pay gap described in the article can be interpreted as a form of economic discrimination against women. The article notes that “men made more than women in every single specialty,” suggesting a discriminatory pattern rather than an incidental occurrence.
• Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of… sex… or other status.
  
  The pay gap is a barrier to the full economic inclusion and empowerment of female PAs. The article suggests solutions to empower women, such as using salary data for negotiation. Todd Pickard advises PAs to “come armed with this knowledge” to “ask for what you’re worth,” which is a direct call for economic empowerment to fight inequality.
• Target 5.5: Ensure women’s full and effective participation and equal opportunities for leadership in political, economic and public life.
  
  While women constitute the majority of the PA profession (“nearly two-thirds female”), the pay disparity indicates a lack of equal opportunity for economic advancement and reward. This financial inequity can hinder their full and effective participation in their economic life.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article provides several explicit quantitative and qualitative indicators that can be used to measure progress.

• Direct Quantitative Indicators:
  • Average Gender Pay Gap in Monetary Value: The article provides a precise overall figure: “an average gap of $20,892 across all specialties.” This serves as a direct indicator for Target 8.5.
  • Pay Gap by Specialty: The article offers specific data points that can be used as indicators for tracking inequality within different fields, such as the “smallest difference in neurology ($10,361) and the largest one in obstetrics-gynecology ($34,069).” Progress would be measured by the reduction of these specific gaps.
  • Proportion of Women in the Profession: The statistic that the profession is “nearly two-thirds female” is an indicator of participation (Target 5.5), which, when contrasted with the pay gap, highlights the severity of the economic inequity.
• Implied Qualitative and Process Indicators:
  • Salary Transparency Policies: The article suggests that employers should “be more transparent about current employee salaries.” The adoption rate of such policies by healthcare organizations could serve as a process indicator for addressing the pay gap.
  • Negotiation Success Rates: The article discusses how women may “negotiate as often as men but don’t get the results men do.” Tracking the success rates and outcomes of salary negotiations by gender would be an indicator of whether systemic biases are being overcome.
  • Availability of Mentorship and Training: The suggestion for “mentorship and negotiation training” implies that the establishment and uptake of such programs could be measured as an indicator of efforts to empower female professionals (Target 10.2).

4. Table of SDGs, Targets, and Indicators

Source: medscape.com