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The Salary-Sharing Taboo


Now that most doctors are salaried, it is time that the long-held taboo of discussing how much money people make is considered for the trash bin as dated and unhelpful.

In a previous article, I noted how people will tell you their most intimate relationship issues and their medical situation without hesitation, but zip their lips when it comes to discussing how much money they make. Now that most doctors are salaried, it is time that this long-held taboo is considered for the trash bin as dated and unhelpful.

Let me tell you a few reasons why.

Jen Doll in The Atlantic points out that “...knowledge is power...(for) salaries.” If there were salary transparency, wage discrimination would wither by public disclosure. And employees would have a better understanding of their bargaining positions.

We can stipulate that setting wages is an inexact science at best. It is based on precedent, some estimation of the current labor market in your specialty and in your area, a review of what other similar folks in the organization are being paid, personal performance, the financial status of the organization overall, etc., as well as the specific circumstances under which your hiring contract was written. And I am assuming (fingers crossed), that you do have a written employment contract, reviewed by your attorney.

With so many recent graduates being hired by large medical groups and hospitals buying up physician's existing practices, it is in the employer's interest to have a simple, hopefully no-haggle “one size fits all” approach, per specialty. But usually it is not in your best interest as the prospective employee to automatically agree to a boiler-plate document. A “standard contract” they'll say, even though no such creature exists.

And some organizations have a sternly worded clause, either in the contract or in the employee handbook, that prohibits the sharing of such salary info. Management has no taste for negotiating potential raises with a doctor who comes armed with external, and especially internal, comparative information.

Happily, a few states, such as California, Colorado, Michigan and Illinois, specifically prohibit such employer intimidation. And there is a bill pending in Congress that would extend that employee protection nationally.

Another factor, according to Doll in The Atlantic, is that the younger generation has become accustomed to “show and tell” previously private information through their experience with social media. Documenting self-disclosure is no longer the presumed threat to privacy that used to be the assumed norm.

Now if you become convinced of the value of this Brave New World approach to salary disclosure, prepare yourself when you broach the topic with your first, and probably most trusted, co-worker. First, do not brag if your salary is higher — be matter-or-fact. The flip side is to be ready for disappointment if your friend has done better so far. Thirdly, be explicit in your mutual plan to take further steps. Do it in, and with, confidence.

You can explain that the good news for your employer, and yes there is some, is that sharing of salary information leads to reduced employee anxiety and increased trust and productivity when there are no salary secrets. Everyone knows where they stand and what conditions apply to future salary adjustment consideration.

Fewer secrets, less corrosion, more trust; it's a win-win. Ah, the Brave New World....

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Victor J. Dzau, MD, gives expert advice
Victor J. Dzau, MD, gives expert advice