Ramkumar Prem N, Bernstein Jenna A, Landy David C, DeMik David E, Deen Justin T, Olsen Reena J, Cohen-Rosenblum Anna
Commons Clinic, Long Beach, CA, USA.
Connecticut Orthopaedics, Hamden, CT, USA.
Arthroplast Today. 2024 Nov 7;30:101554. doi: 10.1016/j.artd.2024.101554. eCollection 2024 Dec.
The increased emphasis on reimbursement, diversity, and burnout in hip and knee arthroplasty necessitates a foundational understanding of the surgeon workforce. The purpose of the study was to cross sectionally survey a representative sample of the AAHKS surgeon membership on the subject of salary, practice patterns, and demographic factors to establish a baseline framework for future advocacy efforts and initiatives.
An online survey was sent to AAHKS members between December 20, 2022 and January 19, 2023. Surgeon demographic data, experience, practice geography and type, and annual case volume were solicited. Univariate and multivariate analyses were performed to describe the association of respondent characteristics with reported salary directly from patient care, as well as indirect revenue streams.
A total of 730 AAHKS members responded to the survey. The largest proportion of surgeons performed 251-400 cases annually (36%); 81% (n = 592) and 93% (n = 679) of respondents identified as white and male, respectively. Case volume was the primary determinant for surgeon salary, followed by practice type, years in practice, and gender. After controlling for confounding variables, multivariate analyses revealed the direct salary of women surgeons was 14.4% less than men [95% confidence interval, 0.4%-28.3%]. When considering indirect revenue, the gender pay gap widened. Salary was not associated with reported hours worked per week, geographic location, or ethnicity.
Salary is an important but underdiscussed subject that reflects the realities of our culture and value system in medicine. A direct relationship between salary and modifiable variables like case volume is clear. However, after controlling for confounders, women arthroplasty surgeons still earn 86 cents on the dollar compared to their male colleagues from direct surgical revenue.
髋关节和膝关节置换术中对报销、多样性及职业倦怠的关注度不断提高，这就需要对外科医生队伍有一个基本的了解。本研究的目的是对美国髋关节与膝关节外科医师协会（AAHKS）外科医生会员的一个代表性样本进行横断面调查，内容涉及薪资、执业模式和人口统计学因素，以便为未来的宣传工作和倡议建立一个基线框架。
在2022年12月20日至2023年1月19日期间向AAHKS会员发送了一份在线调查问卷。收集了外科医生的人口统计学数据、经验、执业地区和类型以及年度病例数量。进行了单变量和多变量分析，以描述受访者特征与直接来自患者护理的报告薪资以及间接收入来源之间的关联。
共有730名AAHKS会员回复了调查。每年进行251 - 400例手术的外科医生比例最大（36%）；分别有81%（n = 592）和93%（n = 679）的受访者为白人和男性。病例数量是外科医生薪资的主要决定因素，其次是执业类型、执业年限和性别。在控制混杂变量后，多变量分析显示女外科医生的直接薪资比男外科医生少14.4%[95%置信区间，0.4% - 28.3%]。考虑间接收入时，性别薪酬差距扩大。薪资与报告的每周工作时长、地理位置或种族无关。
薪资是一个重要但讨论不足的话题，它反映了我们医学文化和价值体系的现实情况。薪资与病例数量等可改变变量之间的直接关系很明显。然而，在控制混杂因素后，与男性同事相比，女性关节置换外科医生从直接手术收入中每美元仍少赚14美分。
