The gender earnings gap among pharmacists

Pharmacist gender and physician acceptance of antibiotic stewardship recommendations: An analysis of the reducing overuse of antibiotics at discharge home intervention

OBJECTIVE

To assess association of pharmacist gender with acceptance of antibiotic stewardship recommendations.

DESIGN

A retrospective evaluation of the Reducing Overuse of Antibiotics at Discharge (ROAD) Home intervention.

SETTING

The study was conducted from May to October 2019 in a single academic medical center.

PARTICIPANTS

The study included patients receiving antibiotics on a hospitalist service who were nearing discharge.

METHODS

During the intervention, clinical pharmacists (none who had specialist postgraduate infectious disease residency training) reviewed patients on antibiotics and led an antibiotic timeout (ie, structured conversation) prior to discharge to improve discharge antibiotic prescribing. We assessed the association of pharmacist gender with acceptance of timeout recommendations by hospitalists using logistic regression controlling for patient characteristics.

RESULTS

Over 6 months, pharmacists conducted 295 timeouts: 158 timeouts (53.6%) were conducted by 12 women, 137 (46.4%) were conducted by 8 men. Pharmacists recommended an antibiotic change in 82 timeouts (27.8%), of which 51 (62.2%) were accepted. Compared to male pharmacists, female pharmacists were less likely to recommend a discharge antibiotic change: 30 (19.0%) of 158 versus 52 (38.0%) of 137 (P < .001). Female pharmacists were also less likely to have a recommendation accepted: 10 (33.3%) of 30 versus 41 (8.8%) of 52 (P < .001). Thus, timeouts conducted by female versus male pharmacists were less likely to result in an antibiotic change: 10 (6.3%) of 158 versus 41 (29.9%) of 137 (P < .001). After adjustments, pharmacist gender remained significantly associated with whether recommended changes were accepted (adjusted odds ratio [aOR], 0.10; 95%confidence interval [CI], 0.03-0.36 for female versus male pharmacists).

CONCLUSIONS

Antibiotic stewardship recommendations made by female clinical pharmacists were less likely to be accepted by hospitalists. Gender bias may play a role in the acceptance of clinical pharmacist recommendations, which could affect patient care and outcomes.

Pharmacy students' perceived willingness and ability to negotiate for paid co-operative education positions

Background

Evidence of a gender wage gap has been identified across many professions, with some evidence in pharmacy. Negotiation is one potential strategy to address this gap and it is underutilized, especially among women. No studies to date have examined pharmacy student perceptions of negotiation when applying for co-operative education positions – a potential sign of willingness to negotiate for entry-level positions upon graduation.

Objectives

To examine pharmacy students' comfort with and ability to engage employers in negotiation over wage and other work-related considerations for mandatory and paid co-operative education work terms at the University of Waterloo (Waterloo, Ontario, Canada).

Methods

Two focus groups, one for female and one for male students, were performed with students who had completed at least one co-operative education placement. Focus groups aimed to elucidate students perceived ability to negotiate with potential employers, to identify strategies that educators can employ to better support students through the hiring and negotiation process, and to elicit student perceptions on the gender wage gap in pharmacy. Focus groups were audio recorded and transcribed verbatim, and data were coded inductively by two independent reviewers, employing thematic analysis.

Results

Three major and two minor themes were identified: Preservation of the relationship; Power differential and perceived ability to negotiate; Institutional support and training; Negative experience with negotiation and wage gaps; and the presence of a gendered approach to negotiation. Pharmacy students rarely engage in negotiation during co-operative hiring processes at the University of Waterloo, with some female students expressing hesitation to negotiate due to concerns about being perceived as “bossy”. Students of both genders felt poorly equipped to engage in negotiation with a potential employer, and lacked confidence in initiating such a conversation.

Conclusions

Students identified a number of factors which influence their ability and desire to negotiate wages during co-op placement, including the requirements and logistics of placements, the perceived power imbalance between students and potential employers, and a concern that any wage negotiation may overshadow the value placed by students on the opportunities to provide patient care. Educators can play a role in equipping students, especially female students, with tools to enter into conversations on wages with potential employers.

A Theoretical Framework for Estimating the Rate of Return to a Pharmacy Education Anywhere

Undertaking a pharmacy education is an investment in human capital. Candidates trade off present versus future costs and benefits. They make this investment with the expectation of earning enough income throughout their worklives to make their undertaking financially worthwhile. Whether or not this occurs is determined by the rate of return. The aim of the current study was to construct a theoretical model to estimate the rate of return to a pharmacy education investment. Specifications for model assumptions, inputs, and outputs are discussed. The outputs are the rates of return, the inputs are the costs and benefits of a pharmacy education, and the assumptions illustrate the circumstances of the individual or group for whom the model is built. The rate of return is the annual percentage that equates the streams of benefits and costs over the investment span. The higher the value of the rate of return to a pharmacy education is, the more profitable is the investment. This theoretical model may be used to estimate the financial viability of pharmacy and compare it to the viability of other professions or to the viability of pharmacy among various locations.

The rate of return to a pharmacy education investment in the U.S

BACKGROUND

Potential pharmacy students need a financial frame of reference to compare alternative fields of study or even determine if studying is financially worthwhile.

OBJECTIVE

Estimate the rate of return to a pharmacy education investment in the U.S.

METHODS

A model is used to estimate the rate of return to a pharmacy education. It is formulated using exclusively present values (i.e., dollars at 2019 prices). Several assumptions are made regarding the individual getting the education, the costs incurred, the amount borrowed, and the benefits derived. The robustness of the model is tested using sensitivity analysis and the rate of return is recalculated each time.

RESULTS

The estimated real rate of return to a pharmacy education investment in the U.S., devoid of inflation and under the assumptions initially postulated in the model, is 4.89%. The nominal rate of return is 6.44%. Post-estimation sensitivity analysis shows that the real rate of return is relatively inelastic with respect to changes in eight inputs considered, thus indicating robustness in the results of the model.

CONCLUSIONS

The real rate of return estimated here establishes pharmacy as a financially viable occupation for young individuals possessing the aptitude and commitment to pursue a patient-centered career in medication management.

A step towards gender equity to strengthen the pharmaceutical workforce during COVID-19

There is plenty of evidence to support that women leaders are needed in the health and pharmaceutical sectors, although most of the leadership positions in global health are predominantly occupied by men. This is a major challenge to global health policy. Gender diversity and inclusion within the pharmaceutical workforce is integral to optimal patient care. Women continue to be underrepresented in senior and leadership positions within pharmacy, despite outnumbering the men in the global pharmacy workforce. This commentary highlights the need towards gender equity and discusses the several key initiatives that are building momentum and making substantial progress towards this agenda in the pharmaceutical workforce.

A Probe into the Wages and Salaries of Health Economics, Outcomes Research, and Market Access Professionals

OBJECTIVE

To estimate the central tendency and spread of health economics, outcomes research, and market access (HE/OR/MA) professionals' wage-and-salary earnings; compare male versus female and US versus non-US earnings levels; and examine inequality in their distribution.

METHODS

Self-reported survey data were collected in 2015 from HE/OR/MA professionals in the HealthEconomics.com global subscriber list. The study design consisted of a two-way classification model with multiple replications and three inequality indicators. HE/OR/MA professionals from the HealthEconomics.com global subscriber list completed a questionnaire. The sample consisted of 403 participants.

RESULTS

Within each location, men earned higher wages and salaries than women, and within each gender, HE/OR/MA professionals living in the USA earned higher wages and salaries than those living outside the USA. Evidence of a gap was suggested by the presence of gender and location disparities in earnings determinants. Results also suggested the presence of moderate inequality that was similar for both genders and greater for non-US than US residents.

CONCLUSIONS

This study shed light into the labor market structure of HE/OR/MA professionals and may be conducive to more rational and efficient workforce management policies.

Pockets of Inequality in the Distribution of U.S. Pharmacists' Wages and Salaries: A Gender Comparison

Background

The literature contains conflicting arguments regarding inequalities in the distribution of U.S. pharmacists' wages and salaries and the existence of a gender earnings gap. Some authors argue that the dispersion is small compared to other professions and there is no gap; others report that after controlling for number of hours worked, human-capital stock, and job-related preferences, male pharmacists earn higher wages and salaries than female pharmacists.

Objectives

Estimate the central tendency and spread of wages and salaries of pharmacists practicing in the U.S., compare earning levels of male and female pharmacists, and examine the pockets of inequality within each gender.

Methods

The study used self-reported survey data collected from a random sample of licensed pharmacists practicing throughout the United States. The sample consisted of 375 men and 279 women. Means and standard deviations of wage-and-salary earnings for male and female pharmacists were estimated by age, number of hours worked, years of professional experience, marital status, type of pharmacy degree, main role as pharmacist, and type of practice site. The spread of wages and salaries within gender was analyzed using the Gini coefficient.

Results

A total of 654 pharmacists provided answers to all relevant questions in the questionnaire (28.9% response rate). Wages and salaries of male pharmacists exceeded those of female pharmacists, but the gap was restricted to practitioners with selected characteristics–older, married, with more experience, whose primary role was dispensing medications, and practicing in a hospital setting. The greatest wage-and-salary inequalities were observed among older pharmacists, with more years of professional experience, and whose primary role was dispensing medications. Different gender-specific pockets of inequality were identified in all variables studied and all categories within these variables.

Conclusion

The seemingly smooth gender-specific distribution of earnings in the pharmacy profession might be the result of opposing trends by different groups of practitioners that cancel each other when analyzed aggregately. By estimating the wages and salaries for selected categories of pharmacists and examining the pockets of inequality within each gender, this study shed light into recent labor market developments and will hopefully stimulate further research into the dynamics of the pharmacist workforce.

Gender and Age Variations in Pharmacists' Job Satisfaction in the United States

While several studies have attested the presence of systematic gender and age variations in pharmacists’ satisfaction with their jobs, only a few of them have considered both classifications simultaneously. None have done so while systematically examining multiple facets of practitioners’ work. This article estimated U.S. pharmacists’ satisfaction levels with various facets of their work, compared them simultaneously between genders and among age groups, and tested for the presence of gender–age interaction effects. The study was based on self-reported survey data collected from 701 pharmacists (31.0% response rate). Mean and standard deviation values for 18 indices related to pharmacists’ work were calculated. When age groups were controlled, female pharmacists expressed overall higher levels of satisfaction with their job than male pharmacists; they also expressed greater satisfaction with multiple specific facets and with the profession, as well as greater workload and stress than male pharmacists. The findings revealed few significant differences among age groups and a limited gender–age interaction effect for pharmacists’ satisfaction with key facets of their work. These findings should contribute to the development and refinement of rational criteria for increasing sources of satisfaction in pharmacy settings.

Gender differences in the measurement of pharmacists' job satisfaction

BACKGROUND

Men and women choose different levels of commitment in their careers and at home. Compared to men, women value the significance of tasks performed and social relations more and earnings less. The objective of this study was to explore whether male and female pharmacists show the same levels of satisfaction overall and with key facets of their job, whether overall satisfaction is associated with satisfaction with 12 key facets of pharmacists' jobs, and whether this association is similar for men and women.

METHODS

The study used self-reported survey data collected from a random sample of licensed pharmacists practicing throughout the United States. The sample consisted of 436 males and 300 females. Pearson correlation coefficients were calculated to assess the association between overall job satisfaction and its key components. The 13 job satisfaction indices and the Pearson correlation coefficient values were compared by gender.

RESULTS

Women were consistently more satisfied than men. Variations in overall job satisfaction were at best accompanied by moderate variations in the 12 job satisfaction facets, raising concerns about the validity of configuring a composite index from multiple indices of satisfaction.

CONCLUSION

The results of this study can be used by healthcare managers and policymakers to facilitate communication, enhance teamwork, and promote a better allocation of scarce resources. Since men and women responded differently to various facets of their jobs, a constant set of rewards and stimulants may not be equally effective for both genders as employers transform the workplace to more adequately meet practitioners' needs and increase their productivity.

A theoretical framework for the interpretation of pharmacist workforce studies throughout the world: The labor supply curve

Despite geographic, financial, and cultural diversity, publications dealing with the pharmacist workforce throughout the world share common concerns and focus on similar topics. Their findings are presented in the literature in a seemingly unrelated way even though they are connected to one another as parts of a comprehensive theoretical structure. The purpose of this paper is to develop a theoretical model that relates some of the most salient topics addressed in the international literature on pharmacist workforce. The model is developed along two fundamental ideas. The first identifies the shape and location of the pharmacist's labor supply curve as the driving force behind all workforce decisions undertaken by pharmacists; the second argues that gender and age differences are two of the most important factors determining the shape and location of this supply curve. The paper then discusses movements along the curve attributed to changes in the wage rate, as well as displacements of the curve attributed to disparities in personal characteristics, investments in human capital, job-related preferences, opinions and perceptions, and institutional rigidities. The focus is on the individual pharmacist, not on groups of pharmacists or the profession as a whole. Works in multiple countries that address each topic are identified. Understanding these considerations is critical as employers' failure to accommodate pharmacists' preferences for work and leisure are associated with negative consequences not only for them but also for the healthcare system as a whole. Possible consequences include excessive job turnover, absenteeism, decreased institutional commitment, and lower quality of work.

Gender Differences in Physician Service Provision Using Medicare Claims Data

OBJECTIVE

To determine differences in the provision of Medicare services based on physician gender in the United States.

PATIENTS AND METHODS

Participants included all 2013 Medicare fee-for-service physicians and their patients, a population that is predominantly older than 65 years. The 2013 Medicare Provider Utilization and Payment Data for services rendered between January 1, 2013, and December 31, 2013, were combined with the 2015 Physician Compare National Downloadable files and 2015 Berenson-Eggers Type of Service classification files. Total fee-for-service Medicare payments and Healthcare Common Procedure Coding System procedure codes for all fee-for-service beneficiaries were aggregated according to physician gender, specialty, years since medical school graduation, and type of service classifications.

RESULTS

Excluding drug reimbursement, the mean total Medicare payments per female physician, compared with those for male physicians, were 41% in surgical specialties, 72% in hospital-based specialties, and 55% across all specialties (P<.001). The mean overall number of unique beneficiary visits per female physician was 59% of that for male physicians (P<.001). By using the Berenson-Eggers Type of Service classification, procedures and other services by female physicians were of 54% lower overall average intensity (allowed payments/number of unique patients) compared with those of male physicians. These differences persisted irrespective of years since medical school graduation (P<.001).

CONCLUSION

Female physicians had smaller average total Medicare payments and fewer unique beneficiary visits than male physicians in the care of fee-for-service Medicare beneficiaries in 2013. The differences persisted across specialty types and years in practice. These data can identify variation but cannot determine causation or explain the reasons behind gender differences. These findings suggest, but do not prove, that female physician Medicare payments are lower due to different practice patterns, consisting of fewer patients cared for and lower intensity of care.

Gender inequalities in the workplace: the effects of organizational structures, processes, practices, and decision makers' sexism

Gender inequality in organizations is a complex phenomenon that can be seen in organizational structures, processes, and practices. For women, some of the most harmful gender inequalities are enacted within human resources (HRs) practices. This is because HR practices (i.e., policies, decision-making, and their enactment) affect the hiring, training, pay, and promotion of women. We propose a model of gender discrimination in HR that emphasizes the reciprocal nature of gender inequalities within organizations. We suggest that gender discrimination in HR-related decision-making and in the enactment of HR practices stems from gender inequalities in broader organizational structures, processes, and practices. This includes leadership, structure, strategy, culture, organizational climate, as well as HR policies. In addition, organizational decision makers' levels of sexism can affect their likelihood of making gender biased HR-related decisions and/or behaving in a sexist manner while enacting HR practices. Importantly, institutional discrimination in organizational structures, processes, and practices play a pre-eminent role because not only do they affect HR practices, they also provide a socializing context for organizational decision makers' levels of hostile and benevolent sexism. Although we portray gender inequality as a self-reinforcing system that can perpetuate discrimination, important levers for reducing discrimination are identified.

Pharmacists' wages and salaries: The part-time versus full-time dichotomy

BACKGROUND

Recent years have seen significant growth in part-time work among pharmacy personnel. If preferences and outlooks of part-time and full-time workers differ, job-related incentives may not have the same effect on both groups; different management practices may be necessary to cope with rapidly evolving workforces.

OBJECTIVE

To compare wage-and-salary responses to the number of hours worked, human-capital stock, and job-related preferences between full-time and part-time pharmacists. The analysis focused on the pharmacist workforce because, unlike other professions, remuneration is fairly linear with respect to the amount of time worked.

METHODS

Data were collected from a self-reported survey of licensed pharmacists in southern Florida (U.S. State). The sample consisted of 979 full-time and 254 part-time respondents. Using ordinary least squares, a model estimated, separately for full-time and part-time pharmacists, annual wage-and-salary earnings as functions of average workweek, human-capital stock, and job-related preferences.

RESULTS

Practitioners working less than 36 h/week were driven almost exclusively by pay, whereas practitioners working 36 h or more exhibited a more comprehensive approach to their work experience that included variables beyond monetary remuneration.

CONCLUSION

Managing part-time pharmacists calls for emphasis on wage-and-salary issues. Job-security and gender- and children-related concerns, such as flexibility, should be oriented toward full-time practitioners.

The life-cycle argument: age as a mediator of pharmacists' earnings

BACKGROUND

Age diversity poses challenges to pharmacy employers and managers. A life-cycle argument has been presented to explain pharmacists' age-related differences at work.

OBJECTIVES

Explore responses of pharmacists' wage-and-salary earnings in three age groups (younger than 40, 40-54 years, and 55 years plus) to labor input and human-capital variables.

METHODS

A survey questionnaire was mailed to registered pharmacists in South Florida, USA. An earnings function was formulated and tested, using ordinary least squares, for each age group separately to compare the direction, magnitude, and statistical significance of each determinant on earnings. The covariates were number of hours worked, type of pharmacy degree, years of professional experience, gender, number of children, and whether the pharmacist had completed a residency and/or attained a specialty board certification.

RESULTS

The model showed better fit and statistical significance for practitioners under 40 and 55 years or older. The number of hours worked was the overwhelming determinant, but the magnitude of its influence was different for the three age groups. Human-capital indicators provided evidence in support of the life-cycle argument.

CONCLUSION

The wage-and-salary earnings of pharmacy practitioners were mediated by age group in their response to labor input and human-capital variables.

Why do Highly Qualified Women (Still) Earn Less? Gender Differences in Long-Term Predictors of Career Success

Our study investigated gender differences in the long-term effects of education, work experience, agentic personality traits, and number of children on career success (i.e., salary) in medicine. German male and female students ( N = 99) were surveyed at a German medical school (T1) and 15 years later (T2). Women interrupted their careers for longer than men ( d = .92). Men had a substantially higher income at T2 ( d = 1.07). Career interruptions, agentic personality traits, and high school grades were significant predictors of salary for both sexes. High final grades at medical school were significantly and positively related to salary but only for men. Low final grades at medical school and number of children predicted the length of career interruptions. For women, number of children was significantly and positively related to career interruptions. For men, number of children was significantly but negatively related to career interruptions. The findings corroborate research from other occupational fields, showing that a discontinuous work history has a negative influence on career success and that human capital variables are better rewarded for men than for women.

Women in pharmacy: A preliminary study of the attitudes and beliefs of pharmacy students

BACKGROUND

Women have historically been attracted to pharmacy because it is widely perceived as a profession that offers them an opportunity to combine a professional career with a family. Women now make up the majority of practising pharmacists in Canada, yet the literature demonstrates disparities such as gender segregation and underrepresentation of women in senior positions. This study was intended to identify the attitudes and beliefs of pharmacy students about women's issues in pharmacy and raise awareness of these issues.

METHODS

First- and fourth-year University of Saskatchewan pharmacy students were invited to share their overall impressions of the status of female pharmacists and the impact of women on the pharmacy profession through an online questionnaire.

RESULTS

Of the 60 respondents, the majority disagreed that there is segregation of men and women in pharmacy. More fourth-year students than first-year students recognized the underrepresentation of women in pharmacy management. Many students believed the number of women in pharmacy would have no negative impact on the profession. Forty students (67.8%) agreed that it is important to maintain a significant proportion of men in pharmacy.

CONCLUSION

Most pharmacy students in this study do not recognize gender disparities present in pharmacy or the impact the disproportionate number of women could have on the profession. Can Pharm J 2013;146:109-116.

Inequalities in the distribution of pharmacists' wage-and-salary earnings: indicators and their development

BACKGROUND

Disparities in wages and salaries can be viewed as the dispersion of a statistical distribution that responds to observed and unobserved characteristics, and reflects socioeconomic phenomena such as the interplay of supply and demand, availability of information, and efficiency of markets in their search for equilibrium.

OBJECTIVES

The aim of this study was to explore the nature of inequality in the distribution of pharmacists' wage-and-salary earnings and establish the extent to which inequality primarily occurred because of variation between/among groups or within groups of pharmacists in several classifications of human-capital and job-related preference variables.

METHODS

Data were collected through the use of a survey questionnaire mailed to registered pharmacists in South Florida, USA. Five indicators of inequality (the log earnings variance, the coefficient of variation, the lower median share, the 90-10 decile ratio, and the Gini coefficient) were estimated for eight human-capital classifications and eight job-related classifications. A one-way ANOVA model was applied to the groups in each classification to compare variation between/among versus within pharmacy groups.

RESULTS

Pharmacists' wage-and-salary earnings were more evenly distributed than most income distributions discussed in the literature. They were more equitably distributed for full-time pharmacists than for all pharmacists in the data set. All five-inequality indicators behaved similarly. Notable differences were observed between/among groups within the gender, age group, marital status, number of children, academic degree, and type of primary pharmacy activity classifications.

CONCLUSION

Inequalities in wages and salaries have been identified both between/among and within pharmacist groups in several classifications using five commonly accepted indicators.

Pharmacists' earnings determinants: differences by ethnic group

Objectives

The purpose of this paper was to explore the behaviour of wage-and-salary earnings of non-Hispanic white, black and Hispanic pharmacists.

Methods

A cross-sectional study was conducted based on the responses to a survey questionnaire. The survey was administered to licensed pharmacists in South Florida between September 2006 and March 2007. The main outcome measures of the study were the response of pharmacists' wage-and-salary earnings to the number of hours worked, human-capital stock and job-related preferences.

Key findings

The earnings responses of non-Hispanic white and Hispanic pharmacists largely conformed to patterns reported in the literature, but the earnings of black pharmacists did not. Significant ethnic differences in the effect of the explanatory variables were detected.

Conclusions

The earnings-determination model developed here was suitable for non-Hispanic white and Hispanic pharmacists, but not for black pharmacists. Pharmacists' earnings-determination processes must address ethnicity-related issues.