Early-career and Fellow Gynecologic Oncologists Perceive Underpreparedness for the Business of Medicine: A Society of Gynecologic Oncology Survey Study
The Payment Reform and Quality Care Subcommittee of HPSE recently published, “Early-career and Fellow Gynecologic Oncologists Perceive Underpreparedness for the Business of Medicine: A Society of Gynecologic Oncology Survey Study,” examining the impact of payment, reimbursement, and academic productivity in career decision-making for early-career (EC) attendings in gynecologic oncology. The study appears in the October issue of Gynecologic Oncology Reports.
The research was led by Jhalak Dholakia, MD, of ECU Health, who, in many ways, was inspired by personal experiences to explore the subject. “I was lucky to have a small business background prior to entering medicine, but I still felt very confused looking at the business of medicine,” she reflects. “Talking with my fellowship peers, many echoed that concepts of compensation and RVUs were like a black box with no approachable entry point.” This realization led Dr. Dholakia and her research team to delve deeper into how well fellows and early-career oncologists understand the business aspect of their profession.
Among the most notable findings of the study was that fellows and early-career gynecologic oncologists are acutely aware of their underpreparedness in areas such as payment structures and reimbursement. This awareness indicates that many have already faced scenarios where additional education could have benefitted them professionally. “To me, this is a great opportunity for SGO to develop programming that directly addresses the knowledge gap,” Dr. Dholakia suggests.
Another striking discovery was that nearly 1 in 5 early-career gynecologic oncologists reported not fully understanding their compensation plan. This figure surprised Dr. Dholakia, who notes, "We are a group of highly driven physicians—we lead trials, perform complex surgeries, and take care of very sick patients. We are absolutely capable of understanding business concepts, yet many of us already in practice have a blind spot that we know relates to our financial health, career planning, professional satisfaction, and burnout." Introducing the conversation about these elements of the field could potentially remove the taboo and open avenues for addressing challenges in a more holistic way.
The study also highlighted significant gender disparities, noting that women in the field reported feeling less comfortable with concepts like work Relative Value Units (RVUs) and productivity than their male colleagues. "Women are less likely to negotiate and often ask for less compared to their male colleagues,” Dr. Dholakia points out. “That societal influence must be acknowledged.” Statistically, there is an increasing number of women in gynecologic oncology, highlighting an ideal opportunity to address these discomforts and cultural norms head-on.
Dr. Dholakia emphasizes the serious career implications of these knowledge gaps, especially for women and underrepresented minorities. "You can't win a game if you don't know the rules,” she says. “Knowledge gaps in the business of medicine represent a targetable weakness but a modifiable one.” Arriving at tangible solutions could mean exploring professional development in a more comprehensive way and investing in research that could have multifaceted and long-term impact on the field.
The study also identifies a link between business unpreparedness and burnout and job dissatisfaction. To address these challenges, Dr. Dholakia suggests introducing career planning techniques early and more formal education on business topics. Educational modules reviewing basic concepts and strong mentorship could prove to be valuable for fostering leadership and practical support during career transitions from fellowship to attending roles. “We have great role models in our field with so much to teach us,” Dr. Dholakia says. “Mentorship is crucial to medical institutions, and professional societies like SGO play a pivotal role in closing these knowledge gaps.” Greater involvement from gynecologic oncologists and a collaborative approach could help societies develop more specialized resources for those at highest risk.
Looking ahead, Dr. Dholakia sees room for further research, particularly qualitative studies that could provide deeper insights into the practical concerns of gynecologic oncologists. For now, this study provides a pivotal starting point for addressing business-related knowledge gaps in gynecologic oncology with significant implications for future career satisfaction, gender equity, and effective professional development.
