Gynecologic surgery: call for reform

In this lecture, I describe historical and other influences that drive "double discrimination" in gynecologic surgery - lower pay in the area of surgery, which boasts the largest proportion of female surgeons, and potentially lower quality care for the field's exclusively female patients. Insurers reimburse procedures for women at a lower rate than similar procedures for men, although there is no medically justifiable reason for this disparity. The wage gap created by lower reimbursement rates disproportionately affects women surgeons who are disproportionately represented among gynecologic surgeons. This contributes to a large wage gap in surgery for women. Finally, poor reimbursement for gynecologic surgery pushes many Ob/Gyn surgeons to preferentially perform obstetric services resulting in a high prevalence of low-volume gynecologic surgeons, a metric that is closely tied to higher complications. Creating equity in reimbursement for gynecologic surgery is one important and ethical step forward to gender equity in medicine for patients and surgeons.