Gender Study of SMCMA Membership Keith Darby, CAE February 5, 2019 General gender, equality, physician magazine, smcma In light of the CMA’s Diversity & Inclusion Technical Advisory Committee (D&I TAC) findings and the current political atmosphere, a comprehensive gender analysis of SMCMA’s Membership has been conducted to determine where, if any, disparities in gender populations exist All data contained within this study was based on membership data reported by either the individual clinician or the clinician’s organization.1 In this study, the primary variable was gender (female, male), which was first compared on a population basis using the most recent US Census estimates and current membership data. The gender variable was then compared using demographic classification categories by age, specialty, and mode of practice. Finally, a review of SMCMA’s Leadership structure was also conducted to gauge representation of membership by those devoted to volunteering their time in support of the organization. The SMCMA is fully committed to equality, and this study was produced as a point of reference and to demonstrate the SMCMA’s dedication to parity within the house of medicine. Population Findings According to the United States Census Bureau, the population of California was estimated at 39,536,653 residents as of July 1, 2017, with a gender breakdown of 50.3% women and 49.7% men.2 San Mateo County had a slightly higher female population within its estimated population of 771,440, with a gender breakdown of 50.7% women and 49.3% men.3 Current SMCMA membership totaled 1,078 active physicians, comprised of 542 female physician members (50.3%) and 536 male physician members (49.7%). 4 This ratio of female to male physicians is identical to the estimated California population and is closely in-line with the population of San Mateo County. Not surprisingly, retired male physicians (345) greatly outnumbered their retired female counterparts (63), which represents 85% male and 15% female, respectively. Oh, how times have changed! Gender Analysis by Age and Membership Years On average, female SMCMA members are seven years younger than their male counterparts, with an average age of 50.3 years old compared to 57.6 years old for male members. Overall, the average age of all SMCMA members who have reported their date of birth is 54.3 years old. In order to determine trending, ages of members were grouped into 10-year clusters and sorted by gender. As you can see in the graph, the percentage of female physicians in each generation decreases with age; conversely, the percentage of male physicians increases with age. This fact is in line with the CMA D&I TAC’s findings, which was summarized by Donaldo Hernandez, MD, who stated that “the California Physician Workforce, in general, is evolving and in fact becoming more female with each generation.”5 It should also be noted that if this trend continues, a drastic shift in SMCMA gender demographics is expected to occur over the next decade as members within the 70+ age cluster retire and those older male-dominated cohorts are replaced with the younger female dominated cohorts. In most cases, the duration of an individual’s membership within the SMCMA/CMA correlates with member age and gender demographics. This demonstrates that the physician workforce is not only becoming more female with each generation, but the population within the house of medicine is also becoming more female as well. Currently, the average duration of membership for female members is 12 years compared to 18 years by male members. Gender Analysis by Specialty SMCMA’s membership is represented by 56 different specialties and sub-specialties, ranging from the primary care specialties to less common sub-specialties such as Neurotology, Forensic Pathology, and Oral & Maxillofacial Surgery. Although a significant amount of overlap exists between many of the specialties identified, this section focuses on the primary practice specialty that has been reported by either the individual member or the member’s organization.1 The five most common specialties identified within SMCMA membership are Primary Care Providers (PCP’s): Internal Medicine, Pediatrics, Family Medicine, Obstetrics & Gynecology, and Emergency Medicine. These specialties account for more than half of the overall SMCMA membership (52.4%), and the proportion of PCP’s totaled 61.2% female compared to 38.8% male. Of these specialties, OB-GYN (83.6%) and Pediatrics (72.2%) were the most female-dominant, while Emergency Medicine was the only PCP specialty in which males outnumbered females (61.0%). All other specialties - representing 47.6% of SMCMA membership - were 61.8% male compared to 38.2% female. In reviewing the 51 non-PCP specialties, all specialties with 10 or more Physicians were grouped together to demonstrate the gender breakdown by those other more frequent specialties within SMCMA membership. The chart on the next page represents 409 physicians, which is 37.9% of total membership. It is interesting to note that of these 17 separate specialties, the only specialties in which females outnumber males are Dermatology, Otolaryngology, and Pathology. One final observation was that any specialty including the term “surgery” was highly male-dominant. This grouping of 92 Physicians – representing 8.5% of the SMCMA Membership - included only 17 female physicians compared to 75 of their male counterparts. This significant gap has long been known within medicine and numerous studies exist that detail the slow progression of women into these surgery specialties. According to the Association of Women Surgeons, women are under-represented in academic roles as women constitute only 8% of Professors, 13% of Associate Professors, and 26% of Assistant Professors of Surgery – while 19.2% of American Surgeons are women.6 Interestingly, most of the findings noted above regarding specialty are closely in alignment with a study of the 2013-2014 graduate medical education class conducted by the American Medical Association.7 Gender Analysis by Mode of Practice To classify physicians into practice types, the following categories were used, which is consistent with definitions used by both SMCMA and the CMA: Very Large: 1,000+ Physicians in a Group Large: 151 to 999 Physicians in a Group Medium: 5 to 150 Physicians in a Group Small / Solo: 1 to 4 Physicians in a Group Other: Hospital-based, Government, Administrative, and Academic Practices As you can see from the Membership by Mode of Practice Graph, more than half of the current SMCMA membership (55.8%) is in the Very Large Group Mode of Practice, which is physicians employed by Kaiser Permanente (TPMG). Large groups, which is primarily employees of the Palo Alto Medical Foundation (PAMF), represents 18.4% of the membership, while all other categories combined total 25.9%. Essentially, 3 of every 4 members of the SMCMA work at either Kaiser or PAMF. As you can see from the Gender by Mode of Practice Chart, the Very Large and Large Groups both employ more female physicians than the 50.3% Membership Population benchmark. Medium, Solo / Small, and Other groups fall well below that threshold When reviewing Mode of Practice, it is important to also understand the age demographics of the physicians employed by those different group types. Average female, male, and total age by each mode of practice can be seen in the table. On average, both female and male physicians employed in the Very Large Group (Kaiser) fall well below their total averages. Conversely, nearly all other categories fall above their total averages. SMCMA Leadership by Gender The SMCMA Board of Directors is comprised of 13 total members, 4 of which serve as Executive Committee Officers (President, President-Elect, Secretary/Treasurer, Immediate Past President), while the remaining 9 are “at-large” Directors. For the 2018-19 term, the SMCMA Board of Directors is comprised of 5 female board members and 8 male board members (38.5% female, 61.5% male). Your current SMCMA President, Dr. Sara Whitehead, is the only female out of the four Executive Committee Officers (25% female, 75% male). Within the CMA House of Delegates, SMCMA is allotted 12 Delegates, and each Delegate has an alternate seat. For the 2018-19 term, the SMCMA delegation filled only 15 of the 24 available seats, with 3 female delegation members and 12 male delegation members (20% female, 80% male). As you can see from these figures, current leadership and the SMCMA Delegation are not entirely representative of the general membership population. However, it should be noted that these are volunteer positions, and those who are more frequently involved in SMCMA activities typically ascend into these leadership positions. As the year-end approaches, SMCMA will be releasing its new committee structure to commence activities for 2019, which will provide an opportunity for each member to become involved with the organization through volunteer service. I urge all members - both female and male - to become involved with your SMCMA to help shape the future of medicine. Keith Darby, CAE is the Executive Director of the SMCMA. References Members are encouraged to maintain their individual information, which is accessible by logging into the self-service portal at https://www.cmadocs.org/profile-update https://www.census.gov/quickfacts/ca https://www.census.gov/quickfacts/sanmateocountycalifornia Membership data as of November 1, 2018 “CMA Section Focuses on Diversity”, Donaldo Hernandez, MD, San Mateo County Physician, Fall 2018 Statistics on the Number of Women Surgeons in the United States, Lahle Wolf, August 2018. https://www.thebalancecareers.com/number-of-women-surgeons-in-the-us-3972900 How Medical Specialties Vary By Gender, Lyndra Vassar, AMA Wire, February 2015. https://wire.ama-assn.org/education/how-medical-specialties-vary-gender << CMA Section Focuses on Diversity RotaCare Provides Care for those with Least Access >>
