Making a Statement: ACC Takes a Stand on Workplace Equity

In a new health policy statement, the American College of Cardiology (ACC) homed in on cardiologist compensation and opportunity equity. The document, published in the Journal of the American College of Cardiology, launches a series of workforce documents that the college plans to undertake in an effort to tackle the lightning-rod issue of workplace equity (online Sept. 16, 2019). 

Noting a salary gap that amounts to male cardiologists earning over $1 million more than their female counterparts over their careers, the ACC offered 17 recommendations for “constructing and implementing compensation models for cardiovascular physicians.” 

The document’s authors, led by Pamela S. Douglas, MD, of Duke University Medical Center, noted that compensation and opportunity inequities may be contributing to the burnout crisis plaguing healthcare. And, they wrote, unequal pay has been associated with the low number of female medical school graduates pursuing careers in cardiology.

“With this policy statement, the ACC intends to provide a clear set of principles related to equity in compensation and opportunity in the professional cardiovascular workspace along with the associated underlying considerations,” Douglas and colleagues wrote. “…  the College believes that cardiologist compensation should be equitable and fair for equivalent work.”

According to the document’s principles, cardiologists’ compensation should be determined objectively by a modeled systems approach that is prospectively developed and based on consensus principles. 

Equity won’t be achieved by tackling only compensation plans, the ACC authors said. Cardiology also needs a more inclusive culture, which would help increase the representation of minorities in the field. Other factors—such as career advancement, the quality of a physician's work, administrative support, clinic time and work environment—also need to be considered. Of the ACC’s 17 principles, three speak to the responsibilities of “cardiology leadership.” These final principles say cardiology leaders should—

› Mitigate the effects of unconscious implicit bias and create a culture of inclusion;  

› Be held accountable for creating and implementing fair policies and adhering to compensation best practices; and 

› With impartial outside experts, regularly and frequently review compensation models, metrics and actual total compensation against national benchmarks. 

“The ACC believes that adherence to these principles will improve the performance and satisfaction of the cardiovascular workforce, enhance team-based care and ultimately benefit patient and population health,” the authors concluded.