Empowering Women Who Are Surgeons with the Data and Tools to Negotiate Their Value
Days when I have the opportunity at work to collaborate with and support fascinating, powerful women who use their skills, talents, and influence to inspire and uplift others are the very best days. I reached out to Sarah Temkin, MD, to talk about her upcoming documentary, 1001 Cuts, a film about women who are surgeons. SCC is proud to partner in this documentary, and I am inspired by Sarah’s mission to tell these stories and her dedication to advancing women in medicine.
Recently Sarah and I spoke via Zoom about the power of negotiation and the need for transparency and equity in the business of medicine. It was a powerful conversation between a woman in medicine and a woman in the business of medicine.
Below, I share some of the highlights from our conversation. You can also watch the full video here.
Sarah – 1001 Cuts
The project (1001 Cuts) really arose from my personal experiences as a surgeon and a woman, but it’s become so much more than that because it has been meaningful to many people. It’s touched a nerve for many surgeons who are women who felt like they were the only person who had these types of experiences of being minimized or dismissed at work or having had their workplace be very dysfunctional or a feeling of not belonging within the profession.
There have been so many physicians and surgeons that have reached out to contribute to this. But also, I think the stories tell a larger story about structural sexism in the workplace and how the work that women do is sometimes devalued, such that women struggle to get the equipment that they need; the equipment they need may not even exist; and certainly, relevant to your work is that women don’t get paid the same and may not even feel comfortable asking for a salary that’s equivalent to what their male colleagues are making.
Jessica – SCC
We’ve talked about how this documentary resonates with women across the board who have these experiences. And that part of the change comes from learning how to negotiate for yourself, stand up for what you need to excel in your job and workplace, and be comfortable doing that. I think men are more comfortable doing that, and it’s more acceptable for them. We need to be part of the change for ourselves, and for the next generation, to have those uncomfortable conversations, to build those muscles, to the point where you understand that when you go into your career, whether it’s medicine or business, that you need to feel comfortable negotiating for yourself and to expect transparency in your compensation, in your benefits, in your support staff, in what administration is going to do, or what your employers are going to do, to help you succeed in your work.
When people have transparency, trust, and psychological safety in the workplace, they perform better. It optimizes their performance for the organization, and in medicine, it increases good patient care.
Sarah – 1001 Cuts
Something that I talked about recently that people didn’t know was that the time you get in the operating room, which is called block time, is incredibly valuable. Because if you have block time at the beginning of the week, then your patients all go home by the weekend, or most of the time go home by the weekend, and it just massively increases your quality of life to not have to worry over your time off or not have to go in and see your patients over the weekend, because they’ve all been discharged home safely.
For many women, there is such a struggle to get just that basic operating room time that they need. I told somebody this the other day that in my first job, the block time that I was assigned was Friday afternoon. So, it wasn’t even Friday morning. And I was like, “Oh, I should have asked for this when I signed my contract; it didn’t even occur to me that I wouldn’t be given these basic building blocks to be able to start and perform my career.
I think we all want to be set up for success, we care about our patients tremendously, and we care about our skillset tremendously. And when you’re not set up for success, it’s a terrible disappointment.
Jessica – SCC
We have to go into our first jobs, every subsequent job and contract, putting that in writing, understanding that nothing is a given, that we need to negotiate these points, we need to know what our counterparts have for block time, for compensation, for benefits. We need to have that information, that data. Then we have to go in and negotiate our value. Trust, but verify is the bottom line, and put it in writing. If it’s not in writing, it didn’t occur.
Administrations change, department chairs change, and hospitals change hands. Women are less likely to negotiate for themselves. They don’t think that they’ll be successful. They’re more pessimistic about the negotiation outcome and expect less money from the get-go than their male counterparts. We cannot acquiesce to that. It’s time to stand up and say, “You know what, this is what the median or the benchmark is for compensation or for productivity.” And to use that data and to go in and negotiate a reasonable contract with the support you need to excel in your job.
Sarah – 1001 Cuts
I always get a little stuck on negotiation. Both people have to come to the table wanting a good faith negotiation. I think a lot of women’s hesitation to negotiate is somewhat rational because, on the other side, the hospitals, their department chairs, or their partners in a practice are at baseline a little less willing to negotiate on things with women than they are with men. So, I think one solution to that, potentially, is for women to help each other negotiate.
When women act on behalf of another woman, it’s perceived as like, “Oh, the mama bear role.” I think that’s one of the other real take-home points or themes of this film. And the experience of talking to so many women who are surgeons is that we all could do a better job helping each other and standing up for other women supporting each other. For too long, it’s been the scarcity model that there’s only going to be one woman who gets the raise, or there’s really going to be one woman who gets a leadership position. Whereas we, I think, can build a bigger pie or a bigger table, where when we, as women, support other women, we actually make the whole system better for everyone.
Jessica – SCC
It’s not a zero-sum game. I don’t have to climb over somebody else to get my share. We all rise together. Your project, what it sheds light on is that none of us are alone in this. We’ve all had, whether it’s in medicine or business or law, we’ve all had similar experiences, but it feels very lonely in a male-dominated field. To know that there are similar stories and smart, dedicated, strong women, who have had those similar experiences who will support you, it’s empowering and inspirational. We need that, especially right now; it takes a village.
We, as women, need to change our mindset, we need to support other women, and we need to get comfortable. My first negotiation with administration was terrible. When I had the data, the training, and the continuing education, I became really effective in negotiating with them.
Sarah – 1001 Cuts
That’s back to that issue of transparency. Also, just negotiating in good faith. I had this happen to me personally, where I showed up, and I didn’t have an office. And you’re like, “Oh, I should’ve asked for an office in my contract. Why didn’t I think of that?”
So, my hope is that by having people negotiate with data and to be rational and transparent about this, we make things better for everyone. And you and I both know that turnover is so expensive.
Jessica – SCC
Absolutely. It’s hundreds of thousands of dollars to replace a physician. Hospitals, by and large, do not want to replace you. They’ve spent tremendous money recruiting you, getting you in place, and investing in you to get your productivity up. You combine that with a market shortage of physicians, which is exacerbated depending on your location. You’re a hot commodity, and it’s extremely disruptive and expensive to lose physicians in a hospital or practice setting. Physicians need to go in knowing what their negotiating strengths are. Everybody should go into a negotiation empowered with the data and the market analysis of where you fit in that market.
Sarah – 1001 Cuts
When women are treated badly in the workplace, to the point that they look for new jobs, they move from their job and leave medicine entirely. I’ve spoken to so many surgeons who just decided that they couldn’t do it anymore because of the accumulation of small aggressions, dismissals, and devaluations of their work. That leaves patients with fewer choices about patient care. Every month, it seems like there’s a new publication demonstrating that patients who have women physicians have better outcomes. It’s good for patient care to keep women in the workforce. There are potentially things that male physicians and male surgeons could learn from their female colleagues if we were valued, respected, and kept in the workforce.
Jessica – SCC
We can’t afford to lose female physicians because of the shortages that are only going to continue to grow. It has been proven that female patients have better outcomes with female physicians and surgeons. To lose that would be a tremendous loss for the system. We need to empower women, physicians, and surgeons, to navigate this, recognize it, and charge at it head on, to understand that there’s gender bias even in workplaces where the majority of the workforce is female. This is ingrained into our society, and we need to recognize that and stand up, and not be self-silenced, with more education on gender bias.
Sarah – 1001 Cuts
Also, I just also know from my own experience and from talking to so many people and from reading literature on this, it’s bad for men too. Men are affected when they witness discrimination or bias in the workplace or harassment, it leads to job dissatisfaction in men. So, our profession’s motto is, do no harm. There shouldn’t be a place for this.
Jessica – SCC
Shortages on a team hurt everybody. That leads to burnout, people feel overwhelmed when there’s a lot of staff turnover, and everyone has to carry more weight. Men obviously love women. They have wives and daughters and mothers and sisters. Encouraging men to say to themselves, “If that were my daughter, is that how I would’ve wanted my colleague to speak to her? I know this doesn’t sit right in my stomach. I’m going to stand up and say something about it.”
Sarah – 1001 Cuts
Absolutely. I think it’s so cool that we’re at this point in history where all these male surgeons are seeing their daughters train as surgeons, and I think it makes it more tangible and real how we can have a bigger tent. That talent doesn’t only come in one body shape and size, and that we, as a profession, can improve and be better by doing so by creating workplaces that are more open and fair and transparent so that we can improve the care that our patients get.
Jessica – SCC
I have two daughters, one in undergrad and one in graduate school, and I want them to negotiate for themselves and to advocate for themselves and their fellow women in the workforce.
For physicians, that needs to happen right out of training in their first job. Knowing that when you sign that contract, and it’s a three-year, five-year contract, that at the end of that three-year contract period, don’t let that contract auto-renew, go back, take a look at it, look at your productivity, look at the new data that’s out and be prepared.
Every time that contract renews, be prepared to do the due diligence and understand what’s changed in the market, where your productivity falls in line with other surgeons and physicians in that specialty, and update your contract. Do that throughout your career.
Sarah – 1001 Cuts
Each individual woman shouldn’t be in a position of having to risk her career herself by asking for things that a hospital system is not willing to give her, but if we normalize this across our culture, hopefully, we can make progress.
If your employer is willing to negotiate with you as a woman and is fair in negotiations, it’s a very good sign that that’s going to be a better and more fair and transparent workplace.
Jessica – SCC
Part of it is physicians knowing what their negotiating power is. I couldn’t do my fiduciary duty for my practice without working on a level playing field. And it changed my perception of recruiting doctors.
I had an open-book policy when I sent a physician a letter of intent to recruit them. I felt that I had more chance of recruiting somebody who knew we were being open and honest about the compensation data and putting productivity targets in their contract that they could meet.
Sarah – 1001 Cuts
Well, that’s what’s so exciting about all of what’s happening right now is that we are leveling the playing field, we’re opening the door, we’re opening the windows and letting the light in so that we can, for ourselves and for the women that come after us, have that more level playing field.
Learn more about this powerful film and watch the full conversation with SCC Founder & CEO Jessica Minesinger here.
For more information about SCC and how we use the latest physician compensation data to help women who are surgeons level the playing field and navigate the business of medicine, contact us today. We’d love to help you, whether you’re entering a new contract, comparing offers, or renegotiating your current surgeon’s contract, or somewhere in between!