In this presentation, we will use information from our payroll register for the month of October to enter the journal entry for October into the general journal posted to the general ledger and record the trial balance with it. To make sure that we pick up the right information, we're going to highlight this information green again. So we're going to go down here. We're going to highlight from B19 all the way over. I should say select it to the X22 and then right click and then I'm going to make it green. I'm going to select this little pane and let's make it a lighter green again. Let's go to the screen here. It's getting lighter each time for some reason. Okay, then we're going to go back up top and let's freeze the panes. So I'm going to put my cursor right on A4 if it's not frozen already. I don't know why I keep unfreezing the pane but we're going to go up top. We're going to go to the view tab. We're going to go to the windows, freeze panes and freeze the pane. Okay, then we're going to scroll back down and this is the data we will be working with. We're going to enter that data into our journal entry tab. So we're going to go to the second tab over here. We're going to have to do some back and forth work between the two tabs. We're going to clean this tab up a little bit. We're going to either unhide or hide what we need. So if anything is hidden in your tab, what you want to do is select whatever cell you can up top and just select the whole thing. Just unhide everything all the way over as far as you need to go. Right click and then unhide anything that's hidden. Then what we're going to do is just hide the cells that we need. So these two are for the first payroll periods. We don't need those now. I don't need those to bother us right now. So we're going to put our cursor on the A and select all the way to the L, A to L. Let go and right click and hide. Then we don't need any of this data. We only need this data to enter this pay period. So I'm going to put my cursor on the R drop down and select all the way to A, C and then left click and hide. Okay, so this is going to be our information. We're going to enter the data here and we're going to post that to the general ledger on this side, which will generate the trial balance. Okay, there's going to be three journal entries, which will be one for the employee's payroll, two for the employer payroll taxes, and then we'll make the payment, which will be the last one, and that'll be on the 15th. So we're going to process the payroll, process it as of November 1st for the payroll period ending in October, and then we'll make the payment in November 15th for the withholdings and the payroll taxes. All right, so note that these are these should look very similar now and we could copy and paste the journal entries from the prior time period and just change the numbers. But we really want it. So just note the repetition there. So could you look at the prior pay period for help? Yes, of course we could. This is accounting. It's very similar from pay period to pay period, but we want to regenerate these because these are things we want to think through. So first, we're going to deal with the payroll journal entry. Now cash is affected, but this is one time I'm going to do that last because we're really working down to the net check. Remember, that's are going to be our goal. We're going to start with the payroll expense, which will be a debit here to 502 salaries and wages. So we're going to copy that, right click and copy. We're going to go a bit faster here. Since we've done this a couple times, it'll be much the same as the prior transactions. So in N5, we're going to right click and paste 123. And then the amount is going to be from the register. So we'll go back to the register and we're looking for the total pay. So here's the regular pay. Here's the total earnings. So we want to pull over the total earnings. So we'll go, I'm going to do that with a formula. So we'll go back to the GL and I'm going to put in cell P5 equals and then go over to the register and we're going to pick up that 487750 and enter. Then we're going to pull over all of the liability accounts that we withheld. So I'm going to go back to the register just to see what we're doing. We're mirroring this calculation. So we've got total earnings minus all these deductions. So we're mirroring these deductions. So we want OASDI, HIFIT, Group Insurance Union and 401k. Those will all be represented by liabilities on our accounts. So we've got not this one, not the payroll. We got FICA for OASDI, HIFIT. Then I'm going to let go not FUTA and SUTA. Those will be involved in the employer taxes. I'm holding down control. We want this 124. Oh, no, we don't want, I'm going to unhighlight that. We want, I'm holding down control, the 225 for FIT, the 243 Group Insurance and the 245 for the union dues. I'm letting go of control, right click and copy. So we'll put that over here in N6 and N6 and right click and paste and we want to paste 123. And then we just need to pull over our amounts. So we'll put our cursor in Q6 and we're going to change the sign to a negative. So instead of hitting equal, we're going to say negative and then go back to the register and we want to pick up this OASDI, enter. Then we're on HI. We want to say negative. We're going to go back to the register for HI, this number and enter. And then the FIT, we're going to say negative. Go back to the register for FIT, this number and enter. And then the group insurance, we're going to say negative. Go back to the register, group insurance and enter. And then union dues, I'm going to put negative. Go back to the register for union and enter. And it looks like we're missing, we're missing the retirement. So I'm going to copy this one, highlight that copy, right click and copy. We'll paste that right here in N11, right click and paste 123. And then we're going to go back to Q11, negative. Go back to the register and pick up the 401K and enter. So now we have, of course, these are the credits, adding up to 20,372. 27 does not equal the debit. If we select all of them, it adds up to what we need, 2770523, the difference, which will be a credit. Now that should match if we go back to the register, the net pay. So that'll equal the net pay. So let's do that. And we're going to see, I'm going to do that with a plug formula, which is negative SUM, double click the SUM function, highlight from the salaries and wages down to the all the, the debits minus the credits, all the debits and credits and enter 2770523, back to the earnings record, just to double check 2770523. So back to the trial balance. Okay. And then so that's going to go to, that's going to be the net check that we're going to pay. So I'm going to take that out of the checking account. So we'll highlight the checking account, right click and copy. We're going to put that in in 12, right click and paste 123. So there's our journal entry. Now we're going to post this to the GL. I'll try to do this a bit faster. So these are all going to be in the same area. So it's going to be easier to find this one's going to be all the way to the end because it's so it's 502. So it's going to be our second income statement account. So we're looking for 502 first, it's in order, assets and then liabilities and then equity and then income and then expenses. So we're looking for 502. Here is our salaries and wages and BM 20111 is the date and in BN 20, I'm going to say equals. I'm just going to hold down the left arrow, which will take us all the way over and scroll up to that 4877 and enter. So there's our amount, our wages, our expenses went up from 96973 50 by 4877 52 145 51. And of course, it's exactly the same because we're mimicking the data from payroll to payroll at this point. So we're going to scroll back over and that's going to be our first one. Now for the rest of them, I'm going to freeze the pains so that this side will remain here every time we scroll over. To do that, I'm going to go to sell ad one. I'm going to go to freeze pains and freeze pains. So then I'm going to scroll over. I'm going to find 215 and we'll just find all of all of these liabilities. That's going to be down here and they should all be pretty close to each other. So I'm not going to go back and forth. In other words, this time we're just going to go scroll this way. We're looking for 215. There's 215 here in as 12, we're going to say 11, one, the date. And then an AT 12 equals point to that 2009 80 81. And there it is. Then we're looking for 220. So that's going to be the next one. So 220 is here in a w 12. As of 11, and then in a X 12 equals that 697 12 and enter. Then for looking for the 225. So we're at 220, 225 should be around here somewhere. We have to skip a couple. It's going to be 225. Here's cell 225 in BE 10, we're going to say 11, one in BF 10 equals. And we're going to point to the 225, which is that 8404 13 and enter. Then we're looking for 243. So 243 looks like it's underneath here 243. I'm on BE 2311 one tab BF 23 equals scrolling up a bit to that 243 that 5500. So there we have that. Then we're looking for 245. 245 is here. Scroll to the right. 245 11 one. And we're going to say this equals. Here's the 245 or picking up that 16, bringing the balance up from 32 by 16 to 48. And then we have the 247. So scrolling down here's the 247 as of 11 one. So in cell BGA 23 equals the 2774 20 and enter. And then the checking account, here's the checking account, that's going to be our first account. So if I put my cursor right to the left of the highlighted cells and go right, we're going to the checking account, which is here on AK 1011 one. We're going to say this equals that 27705 23 and enter, bringing the balance down to 482902. We can see that then on the trial balance here. So if we go back to the trial balance, here's our information on the trial balance. If we scroll back down, we can see now that these totals have pulled over. Now we owe 2980 81 697 8404 FIT and the group insurance down to the retirement. We also note that the salaries expense has gone up here. So we owe more for the salaries that brings net income down. And our debits minus our credits are zero, meaning debits do equal the credits at this time. Next journal entry, we're going to say that we're going to pick up the the employer taxes. So if we go back to the payroll register, we want to pick up this information. Now the employer taxes OASDI HI FUTA SUTA. These two are matching. So we saw that as a deduction in the employee section. These two are employer taxes only federal unemployment, state unemployment. So we'll pick up these numbers back to our our journal. So we're going to say that in essence, we need to pick up the 215, the FICA, the Medicare, the FUTA and SUTA. So these are the ones we want. We're going to highlight those or select those, right click and copy those. We'll put that underneath the date here because they're going to be credits. So it's an N15, right click and paste 123. And then the debit's going to go on top and the debit's going to be the payroll taxes. So 520 here, right click and copy. We're going to put that up top and N14, right click and paste 123. Make this a little smaller. Okay. So now we just need to pull this information. I'm going to pull this information for all the credits. And then the debits will be the sum of them. So we're over here in Q15. Instead of selecting equals, we're going to put negative in order to flip the sign. And then we'll go back to the register here. And we're looking for the OASDI. So that's the one on U23. Enter. Next one, we're in the FICA, HI. And that's the Medicare equals or negative, not equals negative. And then scroll back to our register. We're picking up the HI, the 69712. Enter. Now the FUTA and SUTA are zero. So I'm just going to put zero here. And I'm not even going to post these. I just want to show the symmetry in the journal entry to show them here. And note that they're going to be zero. So note the difference in our journal entry there. Okay. So then we're going to add these up. And they add up to 367793. We're going to put the debit there. We're going to do that with our plug formula, which is negative SUM. Double click the sum function. I'm going to move this out of the way. And we're going to highlight that information. So there's our debit. So there it is. So now we'll post this out. So we're looking for 520 first. That's going to be on our income statement. Here's 520, the third income statement accounts. If we go to the general ledger over here, we've got the assets, we've got the liabilities, then we've got the income statement accounts. We're looking for 520. 520. Here we go. So it's on BQ8111. And then BR8 equals, we'll scroll down just a bit and we want to pick up that 367793, bringing the balance up to 12,67753. If we go to the left of the frozen screens and then click right, then that balance should be here as well. And then we'll post both of these at the same time or without going back to the trial balance. So the 215, if we go to the right, 215 of course is going to be right here. So if we go to the right, we're looking for 215. I think it's going to be up top. Here it is, 215. And now we're on 111 again. So 211, we've got the same amount. It's going to be here again. We're going to say this equals and make sure we're picking up the right journal entry. We don't want this number up here, even though it'll be the same. We want this number there. So we're picking up that 2890 and Enter. It's actually 2980. And then we're going to do the HI, which is 220. So 220, it's going to be right next to it. So here it is on AW13. We're going to say 111. And then in AX13, we will say equals and point to that 69712 and Enter. So there we have that, bringing the balance up here. Now I won't post these two because once again, it doesn't look like, obviously there's nothing there on those two. So we're good there. And so if we go back to our balance, going to the left of the frozen screens and then going down, we see that we should be back in balance here, the effect on net income being the payroll expense portion. At this point in time, we've got these liabilities now that we're going to have to just pay at some point. We took these out of the payroll check and or that's our payroll liability, which we now will have to pay at some point. We're going to say that we're going to pay it on the 15th. So remember the payroll ended in October and then we paid, we processed payroll November 1st. And now we're going to pay it on 1115. So we're basically going to make this payment for these amounts here. So what we're going to do is we're going to take all these amounts that we owe. We're going to make the payment for them. So that includes the, not the payroll tax, the 215, the HI, there's nothing in Futen Suta because those have been totally, the cap has been reached. So therefore we don't owe any money for it. I'm holding down control. I'm letting go here. I'm holding down control and then highlighting the FIT. And that's all we need. The FIT should do it. So we're going to copy that. I'm letting go of control, right click and copy. And that's going to go in in 20 right click and paste 123 values only. So that's going to be what we have now. I'm just going to pick the exact same numbers up here over here in our journal entry. So we'll put our cursor here in Q20 and we're picking up this number. So I'm just going to type it in there negative 5961.61. Then we're picking up this number for HI. So here's HI, we're picking up this number negative, actually, I'm sorry, these should be debits. These should be debits. So I'm going to be on the debit side because we want to make this go down to zero. So we're on the debit side. And this is going to be 5961.61 for the FICA Social Security. The Medicare is going to be 1394.25. And the FIT here will be 8404.14. So that's what we have there. And then we'll sum that up. And that's going to be the cash that's going to come out of cash here. So we'll be in Q23, negative SUM, our plug formula, the sum formula, double click the sum, highlight these cells, and enter. So that's going to be this total that's coming out of cash. So here's cash, going to right click on that copy, scroll down, that's going to be in N23, right click and paste 123. Okay, so now we're just going to post this. So here's 215. Here's 215 on the trial balance. It's going to be the third account that is a liability. So here's assets and then liabilities. And here is 215. So we are on 1115 is the date. And we're in AT14 equals, we're going to point to that 596161. And that's going to bring the balance back down to zero. So note the pattern here, employee portion, employer portion paid both, employee portion, employer portion paid both, employee employer paid both. Okay, and then we're going to do the same for the HI, which is 220, account 220. So here is accounts 220, we're going to say this is 1115. And then we're in AX7AX14 equals and we'll point to this 1394. And that'll bring the balance back down to zero. Again, these are the FICA taxes, same pattern, employee portion, employer portion paid both of them, employee portion, employer portion paid both of them, employee portion, employer portion paid both of them. Now we don't have anything in the HI or I'm sorry, the FUTA or the SUTA. So we can just go to our trial balance over here. I'm just clicked to the right a few times to get to the trial balance. And we're out of balance by that 7355, because we need to record the 225 for the FIT. So scroll back over 225, FIT, FIT 225. So it's 223, 225. So this is on 1115, 225, we're in BF11 equals. Then we scroll back down. Remember to be careful on which which number we're picking up here, we're on the correct journal entry down here. Hopefully I've picked up the correct journal entry every time. And then we've paid that off. So it goes back down to zero.  Okay, and then we're going to go to the cash account. And that of course is our first account here. So we're going to go to cash. Here's cash, it's going to be on 1115, al 11 in al 11, we're going to say equals. Scroll down just a bit, pick up that 15760 and enter. So that brings a balance from 482902 down by 15760 to 46714205. We should see that then on the trial balance here as well. And if we scroll down, we can see that we're back in balance, screen zeros, net income not affected by this last journal entry, no income statement accounts. It's just like paying off accounts payable paying off on account. And it brought down all the payable accounts. So this one went down to zero, zero, zero, we don't own anything there anymore. We're not paying off the group and we're not going to deal with the group insurance union payable, those are just going to go up as a liability perspective. And then we're not focusing there when we're doing the payment methods because those could differ depending on the group insurance that we have and how we're paying off the win and how we pay off the group insurance. And the union, the union dues, we'd obviously pay the union retirement plan. We'd have to set up what, you know, the retirement plan to make sure that we have the contributions made for future obligations there. End simulation, end the simulation!


From Mountain View, California, it's theCUBE, covering the 15th Annual Grow Awards. Brought to you by ACGSV. Hey Lisa Martin with theCUBE on the ground at the Computer History Museum at Mountain View, California for the 15th Annual ACGSV Grow Awards. Can you hear the energy and all the innovation happening behind me? Well I'm here with one of the board members of ACGSV, Ashley Charver, Big Data Evangelist for Cloudera. Ashley, thank you so much for joining me on theCUBE tonight. My pleasure, I'm glad to be here. A lot of collaboration going on behind us, right? It's a great networking event. There's so many people who showed up. There's about, there's over 230 people unexpected tonight, over 100 of those are C-levels. Before we get into your association with ACGSV, talk to us a little bit about what's going on at Cloudera, does the Hortonworks acquisition was just completed the merger a couple months ago? What's going on there? It's very exciting. As most people might know, we just did a major collaboration merger with the company called Hortonworks and the two companies together were about twice the size as we were before and for the industry and for our customers it's been really exciting because we've been able to really create what we call the enterprise data cloud that really enables our customers to bring all their data together into one single platform and we call it an edge to AI solution. We're really one of the only companies right now in the world who have the ability to do that in a comprehensive manner and we can do it on the premise, we can do it in a cloud, a hybrid cloud environment so it gives you the ultimate flexibility and the merger has allowed us to really accomplish that for our customers. As we and every company that's succeeding today is living in this hybrid multi-cloud environment where the edge is proliferating, the security perimeters are morphing dramatically. Companies need to be able to transform digitally in a secure way but also enable access to data from decades ago. Yeah, most anybody who's listening to the media will hear IoT is really the big play and the ability to capture all that data from multiple endpoints, edge devices and bring it all into a single data repository is a major challenge so having the ability to do that in a, you can do it now with the way we're doing it the way your company wants to do it so if you're already in the cloud you can stay there, if you want to keep it on the premise so there's a lot of options that we now bring to the table so hopefully it becomes a little easier for our customers. So when you're talking with customers that maybe have a lot of workloads, enterprise workloads, maybe legacy is still on-prem and you're talking to them and your role as a big data evangelist. Yes. Where does the topic of AI come up?  You've got to go to the cloud to do it? Absolutely, I mean AI is kind of a marketing term that you hear a lot about. For us it's really about machine learning and machine learning is taking large sets of data and putting logic on top of it and so you can tease out valuable insights that you might not otherwise get. So the ability to then apply that in an AI environment becomes extremely important and the ability to do that across a large data set is what's really complicated. But if you're a real data scientist you want to have as much data as you can so your models can run more accurately and as soon as you can do that you'll have the ability to really improve your models, extract better insights out of the data you do own and provide more value to your own company and your own customers. Absolutely, it's a fascinating topic but since we're low on time here we are at the 15th Annual Grow Awards. ACGSV recognizing Arista Networks for the Outstanding Growth Award and Adesto Technologies for the Emerging Growth Award. You've been involved as a board member of ACGSV for about a year now. What makes this organization worthy of your time? Well it's really exciting because in Silicon Valley it's unique because it's all about collaboration. The innovation that we create out of this location to the globe is through networking with our peers and ACG opens up that window, provides a door that allows you to meet with your peers, your competitors, your friends and as a result you can create insights and capabilities about your own company and technology directions that's really helpful. So it's the networking, they also put on excellent C-Circle events which is really good because if your company is looking at growing as a startup you might be able to get some valuable insights from peers who know how to do HR, merger acquisitions, finance and so the ability to do networking like an event like this, the ability to come in and learn how to do business processes more effectively that all plays a really important role at ACG. Well Ashley, thank you so much for carving out some time to join us on theCUBE tonight. My pleasure, thanks for having me. I'm Lisa Martin, you're watching theCUBE.


for the first problem we're going to see what happens if we completely eliminate our use of oil and so to do to do this problem first we just run the control version so we hit run and it says those results that's with all the switches in the off position now we're going to turn the oil switch on we're going to turn f oil new to zero that means oil after the adjustment will represent zero of our energy so that completely eliminates it and remember the renewable fraction will rise as a result of that we have to make sure the start time is a 2020 the adjust time is a 2 we don't change the per capita energy or the population and we run the model again now and we see different result here now I'm going to look at page two this shows the total emissions this is what we're interested in we want to find the total emissions in 2100 and how they differ so I slide the cursor along back and forth here until I get to 2100 that's right in there and I see that in run one that's our control it was 29.57 gigatons of carbon emitted and then in run two it's down to 19.78 and so it's a difference of 9.79 and that's the answer that we're looking for that difference the reduction basically the distance between the blue curve and this dotted red one here


What's good chargeable Ross back again with another video? So Adam hangman page versus CM Punk is official at Double or nothing man, and I'm beyond the switch you guys. I'm excited. I'm excited for this match They've been building it up for weeks. Granted. I know having done a EW live stream in a few weeks I've just been so busy with what we got going on on the main page So I'm gonna try to at some point hopefully next week depending on what my schedule is Try to get an AEW stream in for you guys But I have been like seeing the clips of CM Punk teasing challenging Adam hanging man page for AEW world championship and also I believe Adam ended up catching COVID so he wasn't at last night's dynamite Wishing them a speedy recovery man.  No, it's still out there. People are still catching it So I'm wishing them a speedy recovery On that situation, but they just been teasing it. They've been building it I was surprised he would be his next opponent after the whole At the Adam Adam Cole's little saga they had I wasn't thinking seeing punk was gonna be the next opponent, but they are they are going with it And to be honest with you. I'm interested to see how it plays plays out promo wise CM Punk, we all know he's fantastic on the mic And he has been fantastic on the mic even a little promo he dropped last night I did check it out a clip of it him basically saying, you know, giving Adam his props or whatnot But you know, he's betting on himself man He's betting that he's the next guy to you know, win the AEW championship And in my opinion, I do think that it will be a fantastic match is going to be a great match and also Contrary to people's beliefs where they feel like Adam Adam hangman's page is his title run is kind of mid to them me personally. I enjoy it I I definitely have enjoyed the matches. He's had every single title match He has had since he's won the championship has been Been on point been fire in my opinion, they've been great Maybe some of the the I guess the segments leading up to the match could have been better But my opinion all the championship matches he has had against all the talent He has gone against whether it's one time or two times or three times whatever case may be They were all fantastic all damn near match of the night candidates or match of the night and It's one of those things where I like where a championship in my opinion a championship that has a good Good amount of quality matches make the overall championship run even better Maybe the promos may not be the best Maybe the the setups to these fugues may not be the best But if the matches or stellar is hard to say his championship run has been mid or lackluster in my opinion I've been adjoining it. He has some of the best matches on the card and they're hard-hitting vicious and brutal He's damn, they're bleeding in every single championship match and I'm all for it I'm all all for it and see him punk has been doing some fantastic stuff My best stuff. Well, my favorite things that he has done with AEW so far is obviously the MJ a feud I was kind of you know I was thinking maybe it was gonna extend or maybe they were gonna have at least MJF windy the feud itself But they decided to go with the war low MJF few that they got going on which I've been enjoying as well. We're those getting hella over and I love to see it So I just was really surprised this was happening so soon, but I'm all for see him punk and Adam hangman page for the AEW championship and In my opinion on the booking side of things, I would still have See him punk lose this match. I know some of you guys will all perhaps see him punk win I'm gonna see see him don't see him punk as the AEW champion. I do think it will happen at some time But I think it would probably be better if it was a heel to have the championship rather than a face and They're both faced. They're both over with the crowd I'm gonna go with Adam retaining here only because it's building up his title ring He's beating a lot of credible Champions like credible individuals that have been champions other places over as hell. He's beating them all Beating them even when they tried to cheat whatever the situation is He's beating them all and I like that and see him punk is no exception See him punk can take another loss that that's one of these situations where Even though wins and losses matter and you can tell at least an AEW that they do care about that See him punk losing does not hurt see him punk at the end of the day. He lost to the world champion That's understandable if he's losing to some jobber. That's an issue but if he's losing to a world champion that's been beating the likes of everybody that's Tried to challenge him that are even former world champions in their own right or in other companies top tier man of enters It's okay if you know punk losers. Do they extend the feud? Maybe is it a one and done? I'm not sure I would like I don't know. Maybe I would like to see two matches from it But then you'd be like if you book two matches and you have seen punk lose both then what's going on here So I don't know, you know, I would I definitely would like them to extend it I don't know if it should be a one and done depends on how they book it But in my in my opinion, I do think that see him punk She'll lose this match because he can take a loss and it's just gonna build up Adam Adam Hangman pages title reign until someone actually beats him whether it's a heel or face whoever beats him It'll mean that much more cuz they beat the guy that beat everybody else in good matches And the matches weren't one-sided. So that's just my personal opinion on it I want to get your guys thoughts and opinion on it. Do you guys Think see him punk should beat Adam hangman page at double or nothing Or do you guys think Adam should retain the AEW championship? Are you excited for them finally having this match and it's being a championship match or you guys looking forward to it? And if you do have if you do think Adam hangman page is going to retain the championship Who do you think should be up next to take the title from him? I thought it was gonna be MJF I'm not sure if they or you know holding off on that to have him feud with Wardlow Which is I'm once again another feud I've been enjoying But I don't know I just at one point I was thinking it was gonna be MJF to take the title from them I know MJF have been talking about coming for the AEW world championship Maybe it does happen at some point later down the line. Maybe that is a possibility of that happening. Who knows? I'm not sure who else they would have take the championship from him. So comment down below Let me know some some people you think could possibly do it We're seeing punk is not able to get the job done who you guys think will get the job done But I wanted to make this quick video have been watching AEW just like clips and videos and certain matches I have been watching just to kind of you know, keep up with what's going on Even though I've been live streaming it and I have been loving what they've been doing with the the black pool Wrestling crew dad. Oh man, that's so cool.  That's pretty cool But I appreciate all the love and support man roll to 80k. We're almost there. Appreciate y'all kicking with me See y'all next week


After the failure of Silvergate Bank, Silicon Valley Bank, and Signature Bank, the Federal Reserve Banks announced the following actions at 6.15 p.m. Sunday night, March 12, 2023. The creation of a new bank-term funding program, BTFP, offering loans of up to one year in length to banks, savings associations, credit unions, and other eligible depository institutions pledging U.S. treasuries, mortgage-backed securities, and other qualifying assets as collateral. The Department of the Treasury will make available up to $25 billion as a backstop for the BTFP. The FDIC to complete its resolutions of Silicon Valley Bank and Signature Bank in a manner that fully protect all depositors, both insured and uninsured. Because of the quick actions from the Fed, the U.S. Treasury, and the FDIC, there has not been any more bank failure since after March 12, and the stock market started to rebound on Monday, March 13.


And I have come to be your decluttering coach. Declutter your life of all the stuff you don't need, but you're keeping it anyway.


Yes. Hello, if you're joining us on zoom, could you let me know if you can hear us. Test, test, test, test. Do you have the number like the webinar number I could join. Oh, me. Oh, yeah, yeah. Welcome, those of you joining us on zoom. Can you just confirm you can hear me. Thanks, Myra. We haven't quite started yet. So hopefully you'll hear us better when when we do the introduction. All right, welcome everyone to those of you online and those of you joining in person. I'm really excited about today's talk. We're joined by Dr. Amy Gottlieb, and I'm going to do a quick introduction before she starts into her slides. Dr. Gottlieb is a professor of medicine and OB Guiney and the inaugural associate dean for faculty affairs at the University of Massachusetts Channing Medical Schools regional campus in Springfield, Massachusetts. As a chief faculty development officer at Bay State Health. She also holds a vice president level role in large diversified health system in Western Massachusetts. Dr. Gottlieb received her undergraduate degree in economics from Harvard worked in corporate finance prior to entering medicine. She was at the University of Chicago for her medical degree. We're excited to have her back and then she completed her residency in general internal medicine at Brown. Prior to her current role, she was on faculty at Brown for 10 years and she served in numerous educational, clinical and administrative roles there. She's currently the chair elect for the double AMC group on women in medicine and science steering committee, also known as GWIMS. And the former chair of the Society of General Internal Medicine, Women in Medicine Commission. She's the founder of the Society's career advising program, which I take part and she's an amazing mentor for that. And this sponsors initiative for women faculty and has engaged over 360 participants nationwide since 2013. And in 2020, she received the Elnora M. Rhodes Service Award, symbolizing the highest level of service to the organization. Dr. Gottlieb has led a national efforts to address workplace practices that inadvertently drives salary disparity. And she also has a book closing the gender pay gap in medicine, a roadmap for healthcare organizations and the women physicians who work for them was published in January 2021 by Springer. She also has an article in the New England Journal closing the gender pay gap in medicine, which we'll be discussing with the fellows later today. So it's with that. I welcome Dr. Gottlieb. Welcome. Good afternoon. Can you hear me? Can you hear me? Okay. So thank you so much for this really a tremendous opportunity to be back. It's the first time I've truly been back since I graduated and and I'm just really happy to be here. So I'm going to spend the next, let's see if I'm going to advance my slide here. There we go. I'm going to spend the next 20 minutes or so, 45 minutes or so talking about closing the gender pay gap in medicine. And specifically, I'm going to share some data on the gender pay gap and describe the context in which it emerges. I'll also talk a little bit about the impact of the gender pay gap on accumulated wealth and then do a very deep dive into traditional compensation methodology within academic medicine and the drivers of disparities within that calculus. I'll then talk about organizational strategies to close the gender pay gap in medicine and finish up with a few pearls of wisdom around individual advocacy. I have reserved a nice amount of time at the end for Q&A and very much look forward to that conversation. For the first time in history, the number of women exceeds the number of men in US medical schools. In fact, for 40 years, women have represented a significant proportion of med school graduates and currently account for almost half of medical students, graduate medical trainees and faculty nationwide. Despite this workforce representation, however, women continue to experience well documented disparities in opportunity and compensation within our profession. These inequities are interrelated and addressing one successfully necessarily implies understanding and mitigating the others. We can think of the gender pay gap as a crucible in which all the forces that limit women's professional value within our institutions converge. The equity of opportunity that should be flowing from numeric parity is not materializing. Women's advancement trajectory in academic medicine looks like a funnel. With fewer and fewer women, the higher one goes in seniority and leadership. Women's advancement trajectory on the corporate side of the house of health care looks the same with fewer and fewer women, the higher one climbs in the corporate ladder. In addition to disparities in achieving academic rank and senior organizational leadership roles, the data also demonstrate inequities in obtaining research support and compensation. And these disparities exist even after accounting for age, experience, specialty, productivity, and professional commitment. It's important for me to acknowledge at this juncture that the literature reveals that women of color experience even greater disparities in these domains and face considerable barriers to advancement. So now I'd like to turn to the compensation data. In this country, women physicians earn 72 cents on the dollar compared with their equally talented male counterparts. In fact, the physician gender pay gap has increased over the last several years and based on some seminal work done by Dr Aurora and her colleagues, we now understand that this pay gap amounts to an adjusted career earnings difference of over $2 million on average. Indeed, women physicians experience one of the largest gender pay gaps in the US labor market and the data consistently show that these inequities begin right out of training. Women faculty earn less than men in every specialty and at every academic rank. And as many of you are likely aware, the Association of American Medical Colleges through its annual faculty salary survey collects and publishes compensation data on about 120,000 faculty nationwide. In 2019, the double AMC published this data by gender, and then a few years later in 2021, the double AMC published this data by gender and race and ethnicity. And so we now have the opportunity to look at compensation trends and gaps through an intersectional lens in academic medicine. This 2021 analysis showed that the biggest gender pay gap occurred among physician faculty in clinical departments where women were paid between 67 and 77 cents on the dollar compared with white men. Moreover, women physicians regardless of race or ethnicity earned less than men of every race and ethnicity. Basic science and clinical science PhD faculty tended to do a little bit better with women earning between 68 cents and 89 cents on the dollar compared with white men. So when we translate these advancement and compensation disparities into the healthcare marketplace writ large, it's understandable why women comprise only a small percentage of our top earners in academic medicine despite representing a considerable portion proportion of the physician pipeline. Additionally, advancement disparities and lifetime suppression of wages have considerable impact on the cumulative wealth of women in medicine and science and carry significant implications for retirement choices and post retirement quality of life. I'd like to do a bit of a dive into this concept of accumulated wealth. And in order to do so, I'd like to share a study that was published by some colleagues at Hopkins a few years ago, in which investigators performed an accumulated wealth simulation, in which they looked at over 300 school of medicine faculty salaries about a third were women and longitudinal promotion data over about a decade. Researchers showed they attempted to show the effects of gender differences on total salary and accumulated wealth over a 30 year career, while adjusting for department rank degree and years in rank.  Specifically, in this simulation, owing to the cumulative effect of salary and promotional disparities over a career, a woman faculty member would have to spend her retirement savings at a rate 40% that's 40%, slower than a male counterpart to compensate for less retirement money and longer life expectancy, or if she spent at the same rate, she would run out of money, seven years before her death. So there are multiple inflection points in women's career trajectories, where our traditional way of paying folks of valuing the work that they do disproportionately rewards the way men physicians and faculty have worked and lived for generations. Therefore, it is critical that we identify, acknowledge and address these contextual forces as we said about correcting the practice of paying equally talented women, less than their male counterparts. And so now I'd like to take some time to explore traditional compensation methodology within academic Madison, and its impact on the gender pay gap. Consider that compensation methodology typically rests on a formula of base salary determined by commercially available benchmarking data, plus additional monetary reward for rank leadership and productivity. If the goal is total cash compensation, we can see how common compensation methodology contributes structurally to gender based salary inequities because of women's diminished earning potential in each domain. For example, regarding base salary, there is often a considerable difference between the dollar amounts at the low and high ends of the benchmark ranges, allowing organizations wide birth in making compensation determinations. Salary expectations and vigorousness of negotiation during initial hire are critical to establishing where an individual faculty member falls in that range and are potentially vulnerable to gender bias. Productivity based compensation is impacted negatively by increased demands for organizational service, increased time spent with patients resulting in better outcomes, but lower volumes, and greater responsibility for domestic duties compared with male colleagues. Similarly, limited formal leadership roles and less sponsorship to access those roles decrease the compensation that attaches to those opportunities. I'd like to explore a few of these elements individually and in order to do so, I'll need to describe the phenomenon known as second generation gender bias. So second generation gender bias is different than the sexism that existed pre title seven and pre title nine in that there's not an overt intention to exclude. As I said, these biases are embedded in our unconscious stereotypes and expectations about what leaders look like, and how men and women should behave or how women's work is assigned and valued in our organizations. The descriptive societal and organizational norms are the engines behind why our talented women are failing to reach their potential and being paid less. They are the drivers of the gendered career paths we see in academic medicine, and the consistent observation that women are assigned more non promotable tasks in our organizations and experienced backlash when leading and negotiating. Research reveals that within health care on both the academic and the business sides of the house, women tend to advance in areas that are consultative and supportive, rather than those with significant operational or quantitative or managerial responsibility. In academic medicine, women who advanced to decadent roles tend to do so in faculty affairs, versus in clinical affairs or research affairs and for those of you have been around as long as I have well that's me pre COVID. But you'll recognize my husband Dr. Peter Friedman who was on faculty at University of Chicago is a physician scientist and and has allowed me to use his photo he's a research dean now. On the corporate side of health care it's also important for me to acknowledge that women's C suite leaders similarly tend to hold titles like chief HR officer and chief legal officer. And, and, and the reason these quantitative or operational or significant managerial roles are so critical. Incubators for the dean and the CEO positions but they're also the gateways to the compensation that accrues to those executive leadership opportunities. Similarly, evidence shows that women trainees continue to be directed towards certain specialties like pediatrics that require traditionally feminine attributes and away from technical or more procedural ones like orthopedics. This phenomenon as some of you may know is called occupational gender segregation and it has tremendous consequences for pay equity. In fact in the US labor market writ large a loss of prestige and a decline in earnings have been shown to occur when a large number of women enter a field or occupation. And indeed in a study published just last year in drama pediatrics investigators assessed 70,000 faculty salaries over 95 specialties and showed an $8,000 decline and mean compensation for every 10% increase in the number of women present. And here's a nice visual based on some medscape data that that compels us to consider the following. When an entire specialty loses ground in terms of relative compensation and that's reflected embedded really in our in the salary benchmarks that we use the earning potential of all women entering that field is put a considerable risk.  This is work that has little visibility or impact. It's work that benefits the organization for sure but doesn't contribute necessarily to performance evaluations or metrics for advancement. This is institutional housework and the types of work vary by industry but are readily identified. There's actually some very interesting research around volunteerism in mixed gender groups which shows that women are more likely to volunteer than men. Women receive more requests to volunteer and women are more likely to say yes when asked to volunteer so there is this shared understanding that women will raise their hands to volunteer for citizenship endeavors. Another manifestation of second generation gender bias is that women face a double bind when trying to advance in their careers and when behaving like traditional leaders. In fact, women are often expected to be directive, yet participative, decisive yet caring, executive yet approachable implicit expectations around women's behavior. Women's behavior organizationally and in society at large are often at odds with these well accepted desirable leadership traits and the question is why is that? Well, there are long standing cultural norms, unconscious stereotypes that women are to be nice and caretaking and other focused whereas leaders and high performers are decisive, assertive, and independent and there is a very well described backlash when one's behavior violates these gender stereotypes. There is a social penalty in the workplace for women who behave like traditional leaders and this impacts how they're described and evaluated and dictates how effectively they can self advocate and lead. This likability paradox was highlighted very nicely in a study that was described in Harvard Business Review a few years ago in which investigators looked at 81,000 performance evaluations at the US Naval Academy, both men and women, and showed that women were evaluated more negatively despite no gender differences in objective measures such as grades, fitness scores, or class standing. Women were judged less competent than men of equal qualification and were assigned more negative attributes. Additionally, the most commonly used positive term to describe men was analytical. For women, it was compassionate. Now you may say to me, analytical, compassionate, those are both positive, but which is more valuable from an organizational standpoint. So analytical is task oriented. It speaks to an individual's ability to reason to interpret to strategize. So when considering whom to hire whom to promote whom to compensate, which person which attribute is going to take the prize turning out a negotiation. So to acknowledge that at its essence job negotiation is really an interpersonal exchange between a job seeker and an evaluator and job seekers who violate unconscious stereotypes have been shown to experience backlash backlash in this context is defined as social and economic resistance for engaging in behavior inconsistent with what's expected of one social identity group. The data show that negotiating salary significantly decreases higher ability for women candidates and that men in particular tend to penalize women who negotiate So women and men truly do face different costs when deciding whether or not to initiate salary negotiations. In some women face a unique professional challenge of having an implicit background identity of unconscious social expectations around their behavior that they have to navigate. There's a cultural context in which women must manage the gender expectations of being feminine, while simultaneously fulfilling the requisites of advancement and leadership. And this is costly psychologically and it results in self censorship and attrition with tremendous consequences for career advancement and pay equity. It's also a sub optimal business model because we as organizations truly need to be harnessing the talents of our entire workforce. As we consider how elements of second generation gender bias can undermine the productivity element in the domain in the domain on this figure within our traditional compensation calculus we really need to look no further than the pandemic. As many folks know the pandemic has had a regressive effect on women in the workplace in general into the before 2020, all recessions depressed employment equally for men and women or depressed, depressed employment for men more. However, in the coven 19 pandemic, the job losses were much higher for women. The reason behind this is that women were heavily employed by sec infect and sectors affected by the shutdowns and had to shoulder increased childcare responsibilities because of school and daycare closures and remote learning. The economic data were clear and consistent that mothers work hours fell significantly more than that of fathers and that unfortunately working remotely did not mitigate this disparity for mothers of young children. Personally, my most compelling data point was with return to remote schooling in September of 2020 it's hard to believe it's two years ago, 80% of the individuals who left the workforce that's 80 were women that's almost a million women. The reason this is important to talk about in terms of today's topic of closing the gender pay gap in medicine is that worker historic trends tell us that workers who diminish employment during a recession experience highly persistent earnings losses and diminished career opportunities. Now we all know that the health care sector has been significantly disrupted during COVID. And when we look at our industry in particular, the data show that women in medicine and science indeed, we're doing more double shift work have been doing more double shift work during the pandemic. In the pre pandemic, there were decades of data, revealing that women, women faculty should shoulder to increase responsibilities for dependent care domestic duties and childcare disruptions, compared with male colleagues and now there's evidence of more household responsibilities and childcare reduced work hours and less academic productivity during the pandemic than men, and this labor force disengagement has tremendous implications for future productivity compensation and career advancement, and has been referred to in the literature as economic scarring. So when talking about the productivity component of traditional compensation methodology, I would be remiss if I didn't spend a few minutes talking about the RVU conundrum. Everybody's favorite topic the RVU. So the relative value unit as I'm sure you all know was adopted by CMS in the early 90s as a mechanism for physician payment. The standardized unit based on the cost of providing medical services and physician work comprises over half the valuation. Now there is considerable consternation in the literature over the questionable methodology that underlies this evaluation of physician work because it's based on surveys of physicians who perform the service. The survey response rate is low. And of course it's subjective. It's also designed to value medical services, not to measure physician performance and as such it incentivizes more, but not necessarily better work. This volume based productivity has been characterized as an imperfect measure of physician work that is inconsistent with 21st century healthcare goals, like patient centered care and teamwork and quality. What I would describe as potentially monetizing the doctor patient relationship. I would certainly offer that it penalizes women who spend more time with patients engaging in more patient centered communication who demonstrate better outcomes, but lower volumes. Women also have limited access to highly remunerative RVUs because they're over represented as I mentioned in non procedural specialties. But even for those women who do perform procedures they receive fewer referrals for them, and they perform lower value procedures. I don't know if there are any surgeons in the room, but the surgical community has been paying increased attention to how implicit gender bias is impacting the valuation of productivity. In particular, just last year late last year a large and very elegant study was published in drama surgery in which 40 in which investigators looked at 40 million referrals to surgeons over a 20 year period, and showed that male physicians were more likely to refer patients to male surgeons. Women surgeons received fewer procedural referrals, and unfortunately, these findings did not attenuate over time. This same group of investigators published a study a few years prior in which they looked at about a million and a half procedures, and revealed that women surgeons more commonly performed procedures that garnered the lowest hourly earnings. To that same and colleagues from multiple fields have been publishing about the bias valuation of female specific procedures, compared with male specific procedures, despite similar complexity about the potential impact of this disparate reimbursement on quality. And last but not least about the bias perceptions among referring physicians who have been shown to penalize women surgeons more for bad outcomes and reward men surgeons more for good outcomes that last bit of data actually comes from somebody on faculty at University of Chicago and the Department of Economics very interesting work. Last we think the silver bullet to improving productivity based compensation is incorporating alternative payment models into our salary determination processes, we need to look at a recent study that raises concerns that these new frameworks the APMs may be recapitulating existing gender biases. So just in July, the annals of internal medicine published another incredibly elegant study in which researchers looked at a micro simulation of over 1400 match primary care physicians. The investigator showed that the gender pay gap was similar under unadjusted capitation and productivity based models, however, the compelling finding was that there were larger wage gaps under capitation models use that used diagnosis based risk adjustment. Male PCPs had panels that had more men who had higher risk force and so this begs the question. Are our risk for algorithms, up waiting conditions, more prevalent and more often diagnosed in men. So now I'd like to switch tax a little bit and talk about what we can do about closing the gender pay gap in Madison we start an organizational level let's peel the onion back a little bit. What about correcting the practice of paying equally talented women, less than their male counterparts, it's critical as I hope I've communicated that we identify acknowledge and address the contextual forces that perpetuate it. In parallel, however, we must recognize that equitable compensation is a business endeavor that requires the same attention to detail and rigor afforded other operating costs. The gender pay gap in medicine will require our colleagues in finance and HR to take a good hard look at basic assumptions underlying institutional compensation methodologies to understand the expectations and the outcomes. They generate to create new approaches that better account for the unique contributions of women, and the biases facing them, and to track and report gender metrics at all compensation touch points. To argue with equal pay for equal work. It's how to achieve this goal that overwhelms institutions and their leaders organizations need a roadmap to assess how current compensation methodologies at home are perpetuating pay inequities. This is the governance structures coalitions and processes necessary to incorporate equity principles into routine business practices, and how to create the dialogue consistent messaging and cascaded information to achieve organizational transformation around gender equity. As Dr Euler mentioned about almost two years ago some colleagues of mine and I published a book that aims to help institutions with this endeavor and and I put up the link here if anybody's interested. We also must recognize the importance of culture change to this endeavor, as I'm sure everybody in the audience knows culture is defined as a set of collective norms and behaviors. And there are certain elements of culture chains that are critical, fostering organizational conversations like this is one of those elements. As is intentionally reshaping practices and patterns of interaction in our workplaces that inadvertently benefit men disadvantage women and drive the gender pay gap. What we're really talking about here is building cultures in which men and women are not limited by role expectations. This endeavor like most things in life begins with ourselves with self reflection around our own perceptions and decision makings. We need to start by being mindful of the language we use in our introductions and our evaluations implicit biases communicate in linguistically communicate stereotypes and contribute to the maintenance of gender norms that women have less standing and less expertise. The data show that women physicians and faculty are introduced with their professional titles considerably less often than men are and are evaluated with fewer standard adjectives despite similar qualifications with male colleagues. We also have to be paying attention to the processes in which unconscious biases could emerge. And last but not least, we need to be sponsoring high potential women for leadership opportunities. In the vein of paying attention we can only manage what we measure. And so if folks are not already doing so we should be tracking gender representation along the career continuum, expecting unconscious bias training of everyone involved in recruitment hiring evaluation promotion and salary setting. And we also need to be conducting regular salary audits, especially for initial hires of a folks right out of training. I'd like to talk in detail about sponsorship. Sponsorship is critical to operationalizing the value of equal opportunity within an organizational culture by helping to dismantle second generation gender biases. Women in medicine and science have a visibility gap and sponsorship facilitates access to the platforms and networks necessary for talent and merit to become visible, recognized and rewarded. Now I'm sure a lot of you understand the differences between mentorship and sponsorship so I'm just going to take a minute to review those. Sponsorship tends to center on personal and professional development. It's about skill building and goal setting a mentor is somebody who provides feedback and expertise but whose impact truly does not depend on rank or position. Sponsor, however, focuses squarely on enhancing visibility credibility and networks, a sponsor is somebody who facilitates recognition and access and whose impact depends on position and our organizational influence. There are some limitations to mentorship or traditional mentorship in terms of supporting upward career mobility because of mentorships traditionally narrow scope say for example around a research project, and it's focused on mentee behavior. Sponsorship, however, directly targets career advancement and it's anchored in a sponsor's awareness of organizational structures and opportunities, and its focus is persuading institutional decision makers to see a protege's capabilities. This is a Venn diagram from some very close colleagues at Hopkins and I love it for many reasons and how it how it describes mentorship and sponsorship I want to point out a couple in particular. So mentorship is often longitudinal and can be quite transformative, whereas sponsorship may be episodic and feel a little bit transactional. The business community has known about and published about the value of sponsorship for over a decade, specifically about how sponsorship helps folks gain promotion, it increases satisfaction with rates of advancement, facilitate stretch assignments improves gender parity and advancement and puts upward pressure on pay. Academic Medicine came to the table a little bit late, but I would argue that as early as 2014 for Sheldia Castro and her colleagues at University of Michigan published a study where they didn't use the term sponsorship but really they were describing the concept and in that work. The investigators looked at a large K cohort and showed that promoting a mentee's career through networking and advocating for the mentee influence career satisfaction. I would argue that networking and advocacy on behalf of a mentee is sponsorship. A few years later patent colleagues also from Michigan looked at another group of K awardees and showed that reported sponsorship experiences were significantly associated with academic success. Academic success in this context was defined as for achievements such as a certain number of peer reviewed pubs a certain amount of external funding and formal leadership roles. That same year Dr breeder Roy and I published some early data on a nationwide sponsorship program that I had established for the Society of General Internal Medicine. The code was that participants in the program reported promotion to the next rank and expanded job opportunities in association with their engagement with the initiative. It's very important that we are intentional about sponsoring women in medicine and science because sponsorship that happens informally, or without a mandate for inclusion, most often benefits white men. And this figure underscores very nicely how this is from patent study how men in academic medicine were reporting more sponsorship experiences than their women colleagues. What is sponsorship look like on the ground as I said intentionality is is essential structure programs on a proponent of structure programs because they can proactively link. Protegees with sponsors based on standardized criteria, they can thoughtfully match sponsors and protegees, set out clear expectations for engagement identify objectives, monitor outcomes and solicit feedback for improvement. It's critical that our top leaders are sponsors and and promote sponsorship as an organizational value. Some may say why is she going on about sponsorship we're talking about comp. Well, to bring it back to compensation and to to to underscore the importance of sponsorship and leadership opportunity, as they relate to compensation I'd like to share the Mayo Clinic experience. So some of you may be aware that the Mayo Clinic has had a salary only model for for decades. There's a target salary that's established for each specialty it's non negotiable. A few years ago some colleagues at the Mayo Clinic decided they wanted to assess how they were doing in terms of pay equity and in fact they did affirm it in 96% of cases. One of the main drivers of that remaining 4% was that there were there were more men in compensable leadership roles. So intentionally sponsoring women for formal leadership positions is meaningful work in terms of helping to close the gender pay gap. We have to remind ourselves that talent is universal, but opportunity is not and sponsorship provides that opportunity. I wholeheartedly believe that the primary responsibility for solving this gender pay equity conundrum rests on the shoulders of our organizations for all the reasons that I've elucidated. In an individual level, however, the most critical contributor to pay equity is understanding the playing field, the rules of the game. Since implicit gender bias limits, women's ability to negotiate successfully the burden of salary equity truly does lie beyond the full control of an individual candidate. However, until organizations undertake the effort to address this phenomenon systematically, it will be essential for women faculty to equip themselves with knowledge about salary benchmarks, institutional target ranges and metrics for placement in those ranges in order to support their being paid equity. Several commercially available benchmarking salary benchmarking data sets. One of the most commonly used in academic medicine is the faculty salary survey from the Association of American Medical Colleges that I've already referenced. The double amc several years ago intentionally made this data set affordable for purchase online it's actually $45 it went up. But it's, it's affordable and available, knowing that there are well described penalties for self advocacy around salary and resources I would encourage women to use appreciative inquiry and approach the exchange around compensation as a conversation rather than a negotiation and to prepare for that conversation. I would also offer that an institution or institutional leaders willingness and response to this discussion have this discussion is a good indicator around institutional culture related to equity and inclusion. Last but not least it's, it's important for me to, to mention this incredible statutory effort around this country, regarding pay equity in the last six or seven years hundreds of bills have addressing pay equity have been introduced at the state level to include more aggressive pay equity laws, wage transparency laws and bands on salary history inquiries. And this last group the salary history bands were were intentionally put in place to prevent successive employers from using past discriminatorily low compensation to justify pay disparities. You know, Illinois does have a salary a band on on asking about salary history and if you land in another state, I put up the website here you can go to and just plug in your locale it will tell you if there's a salary history band in place. To close the gender pay gap in medicine organizations will need to identify and explore factors that drive compensation calculations at home, and to develop frameworks that account for gender inequities that it when assessing experience performance and responsibilities and that also recognize and reward mission aligned pockets of productivity that are currently being ignored. I'm going to leave you all with a call to action to start somewhere to do something. If you're not already doing so start conducting regular salary audits to determine where where the salary inequities lie. If that's already happening, identify where along that career continuum the gender pay gap is the most concerning and then review compensation methodology at that inflection point and consider potential drivers of disparities and then pick a driver and tackle it. Identify salary benchmark standards if none exists, minimize the potential for that salary negotiations for junior faculty right out of training, acknowledge and account for gender inequities and biases inherent in clinical medicine. I'm often asked as you might imagine where I would begin, I would equalize starting salaries right out of training salary disparities among graduating trainees are not rationalizable. And there is very good data that closing these pay gaps will have considerable financial impact to the tune of hundreds of thousands of dollars. I would also intentionally support the academic promotion of women faculty, we also know that closing the gaps in promotion timing will have financial impact. So here are all my references. I studied under Dr. Siegler so I have a lot of them. And I'm going to leave you with one of my favorite quotes, which is from I to be wells. The way to right wrongs is to turn the light of truth upon them. Thank you so much. Wonderful. Thank you so we are going to be open for questions in the room if you have questions we also have a question from the zoom so I'm just going to start with the zoom question. And I'll read it from Jay Carlson, and he's referencing pharmacists and their approach to equity and pharmacy he said Claudia golden has argued that pharmacists have largely closed the gender pay gap in their industry by developing substitutable workers that allows for flexible hours to individuals can better balance work requirements with domestic responsibilities. What do you think about the possibility of applying these solutions to physicians. I love that question and the pharmacy literature is really interesting in this and I couldn't agree more I think there are many layers to that onion and while it is very tempting to try to solve everything at once we really do need to be focused on what pharmacy has done in terms of really a culture rating flexible work time scheduled work time has made it a lot easier for that productivity domain to be managed in terms of our compensation methodology. Any questions from the audience. Dr. I'm just going to repeat the question. Yeah, so Dr asked about strategies for women in leadership to overcome the bias. That's a great question. Thank you Dr. My answer is a little polemical I have to be honest. This is this is not going to be solved on the backs of women. This is a cultural challenge. And I think having conversations like this is real is the first step. I'm going to take this very seriously because as as my my talk implies there are far reaching implications of of this inherent bias against self advocacy and and negotiation which are part and parcel right of being a good leader. I would also say that there is data from the higher ed community that the more women we get in power in leadership, the more that it's an association it's not causation but it's associated with better outcomes around representation for women and compensation While that may not be a satisfying answer because I wish I could give a pearl of wisdom to an individual woman who is stepping on that trajectory of leadership I really do think it's on the shoulders of our organizations to have conversations like this and to make us all aware I mean we all I think could all do better at just stopping and taking a pause particularly in amongst processes like hiring like compensation setting to check in with ourselves about what are our perspectives are individually. So I'll just paraphrase quickly Dr brunette shared that as she evaluated salaries in her section that she noticed this what you mentioned about leadership, the leadership gap and wanted to ask for recommendations about how to address that. That's a really great question and I you know I don't I think we're always going to need and want leadership premiums so I think that that piece is set it's how to get more women into those roles and I think it starts with kind of the. You know democratization of opportunity and and so when our institutions and our HR folks have to be very cognizant of publicizing opportunities widely, even if they're informal. And that actually gets at the citizens since and chip tasks to and so I think, making opportunities widely known to your point, Dr brunette encouraging folks of all genders to apply for those roles. And, and then having some type of it I'm a huge proponent of checks and balance processes in terms of having some type of institutional oversight to to identify and explore when a finding like that occurs and ask why and what are some kind of on the ground local efforts that could be made. In addition to leadership development curricula like the ones that you run. There's another question from the chat with Polly Gandhi hospital administrators sometimes think that there is no productive if there is no productivity component to compensation physicians will become lazy and not perform at their best. Any advice and how to overcome this argument and also how to appease the high producers other than then that others are not being given a free ride if the compensations are not made equal. So that's a summit and actually something I've been thinking about for my next book that is really counting work. I think is we that's that's really what the Holy Grail is for academic Madison how we count work and so all your your the elements of your question are are really insightful and this is not going to be a satisfactory answer because it really is a long conversation. But I think that the belief in RV use and in terms of physician motivate as a physician motivator is not data driven. It's it's also a flawed it's both the RVU is both a flawed construct and a flawed concept and construct we talked about because the methodology is pretty weak. In terms of the concept, I would argue and you know there is some and I am not a behavioral economist but there is some nice literature in that domain about what motivates physicians and other professionals. And I would argue that we need to talk to talk and think and adapt our metrics around that a little bit better. And then last but not least I would say that you know the RVU feels good in the short term right because it's countable. It's some, it's easily countable. But in the long term and this is another calculus that needs to be looked at strategically. I would argue that it's very expensive for institutions and for our professions you know we are having a tremendous scourge of burnout and attrition, and it's costly to recruit and new physicians when folks leave and new faculty when folks leave so we need to be thinking about those costs opportunity costs as well and as I mentioned this is a longer conversation and you know I'm really sorry that that's what you're experiencing and I go all over the country talking about this and you're not you're not alone. I had one question. There was recent Harvard Business Review article saying that in business, they find that women start at the same salary but it's really this mid career where women that were the discrepancy is, and we were interviewed for that and tried to reflect on is that the same in medicine are different and I just love to hear your opinions about that. So in Madison there are, there's as I put on one of the slide there's disparities right out of the gate, which is, is, you know heartbreaking. I will say that the gender pay gap gets worse, typically, and, and for all the reasons that you've outlined, and so, so I do think that similar to what I said to in response to Dr. Burnett's question that having processes in place for those inflection points, promotion to associate professor or you know seven years in the rank of associate professor and what's happening and looking at not just academic and organizational advancement but how compensation is also being tied to that. Any other questions in the room or on zoom. So I'll try to summarize this question is about the double AMC data and could the, could the double AMC be transparent and show which institutions are high performers which are low performers, and that would then challenge institutions to be better and use the data. So, as, as Amy Gottlieb private citizen, not Amy Gottlieb who is the, got to be chair of the double AMC's group on women and medicine science I will say that I'm a huge fan of the Athena swan style of scorecarding and, and I do believe that so so for those in the room but that's a reference to essentially an enterprise that ranks organizations in the UK, based on their equity at gender equity and tie it's tied to funding and for research funding and so I am a huge, huge fan of scorecarding. And so being said, the double AMC is, you know, walks, I think a very important line and that it aims to help its member organizations move the needle in a way that is supportive and sometimes I think scorecarding is not as supportive. And so I will say that certainly in my tenure on the group on women and medicine and science which is now, I mean, a long time. There are persistent conversations about how the organization can use its data to, to, to support and achieve gender equity and this, these salary reports, 2019 2021 were directly the result of those conversations because as I'm lost in anyone in this room back in my day so when I was junior faculty to negotiate, you know, go into a salary conversation to get that double AMC data was like you had to go in the dark of night and beg an administrator and it was impossible and you can't have a fair conversation. So half the room doesn't understand what data we're talking about. So, so all that data transparency and the double AMC is actually about to come out with even more in the Dean suite this month and beginning of November. And so that's I think how they I know that's how they're trying to lead in this round. Great question. Right. So the double AMC and I unfortunately I'm embargoed so I can't talk a lot about it but there will be a lot of really nice data coming out in the, in the next couple weeks about academic medical leadership and compensation. Is there any questions in the room or over zoom. Oh, Dr. Siegler. Yeah, so Dr. see the photos on zoom Dr. Siegler is referencing his medical school graduation 1963 did I get the data right. And it was three women and 73 men and was just, you know, saying that he's seen a lot of change and hoping that'll change. I think the question for me is how fast, you know, because it's been a little slow for some of us. He asked me the differential diagnosis of respiratory alkalosis which you did ask me 25 years ago on the wards. True story. You know, so, so the arc of history is long in bed source justice right I mean that's kind of what you're getting at and I would argue to so Dr. Siegler I agree with you I also think you know there's some really good data that was published by Kim Richter out of Kansas. At this point like two and a half years ago she looked at all the med school graduates over 35 years and the advancement disparities in achieving senior academic rank and there's actually been almost no movement or even negative movement towards professor. And so I hope you're right, I do think that we, these kinds of conversations hopefully will expedite it a little bit more. I can't see the hand in the chat but I can't I can't see that I don't know if you can say your question verbally but if you want to type it in the chat that's fine. Any other questions. So, so we're going to stop the recording and then for those of you who want to say the ethics fellows will have a little bit of time with Dr. Dr. Gottlieb and perhaps to ask about her practical experience at Bay State what she does and how this equity work kind of works in practice at Bay State so


Our next panelist is Sasha Taylor of Black and Pink. Good evening everybody, I'm Sasha Taylor. I am a transsexual, just y'all know. Not that that matters, but the only reason I say that is because a lot of times we get really looked over a lot of times in prison and we don't get the recognition that we deserve proper treatment or medical treatment or any kind of good treatment in prison. I did six years in a federal prison and I met my partner there, so just to throw that in there, I'm very happy about that. And my experience in prison wasn't that bad, honest to say, only because I applied myself a different way as far as what I saw other prisoners being treated. Other people that were likely in prison saw them get treated a lot worse, but it also had to do with the way they acted in prison. I tried to carry myself with respect and dignity to where people wouldn't bother me in any certain way. And I managed to do some college while I was there and get my art going, because I'm an artist, and also learn how to play guitar and sing in the advanced. So I try to do the best of a bad situation. Right now, while I was there, I now work with an organization called Black and Pink and they're an abolitionist group which works to abolish prisons and tear down the fences. What exactly they are is an open family of LGBTQ prisoners and free-world allies who support each other and the work that they do is toward the abolitionists of prison industrial conflicts and it's rooted in the experience of currently and formerly incarcerated people. They're outraged by the specific violence of their conflicts against the LGBTQ people and respond through advocacy, education, and direct service and organizing. We just celebrated our 10-year anniversary with a big celebration of over 600 people in Boston, Massachusetts. That's where they're based at. They're on Facebook and they're online at Black and Pink.org. So if you're more than welcome to look them up, they have at least 2,000. When I left prison, there was 1,500 in the organization. Now there's over 2,800 people that are in the organization. They provide a newsletter for all inmates and formerly incarcerated people that are outside of the world and families to keep them connected with people in prison. Our gay community here in San Antonio is the younger generation. I'm 40 years old and people in my age group are a little apprehensive of helping groups like this or organizations like this.  It's one thing to fight for a transsexual to go to the bathroom that they feel is safe for them but it's another thing to fight for people to exactly have that family member here, period, because they're stuck in prison where they have no choices. You've got to follow their procedures and their rules and they have no voice in the matter. I do want to give a highlight on the event of me being in prison when I got transferred to Loretto, Pennsylvania. I originally was in Beaumont Federal Prison in Loretto, Pennsylvania. I single-handedly got the psychology department.  So I provided books for them and they put them in their library. They also took every single person who works there and they would do a rotation. And what they did is they took them to a course. It's not sensitivity training, as they call it. It was the actual course that they took on how to better... English language is so ugly. Better deal with people like me or their homosexual or transgender and that's what they did. They took a class. So I just want to let you know what I did there. As I was stating earlier, just to reiterate something that I did, while there in federal prison, some of the important things to do is if you have any family members that are in prison, just constantly keep in contact with them and don't ignore any help that they need. And they start to provide email service and everything else, limited. Don't ignore any requests that they have. I know it's real hard to be in there. I don't know how many people in here have been in TTCJ or federal prison or county jail. I've only been in two of those situations. County jail is not fun. Jail is not fun, period. And county jail is not exactly... federal county jail is not exactly a thorough place at all. Federal prison was a whole lot easier for me to get through only because I pushed boundaries. I pushed the issues on a lot of things. I had to fight to get medical help while I was there and getting about a stack this high of paperwork from University Hospital having to weed through that and they gave me a pectic problem about going through all my paperwork and everything until I found out this is what I needed just to get my hormone pills while I was there. It'll make it very easy. And then in turn, I ended up getting two people fired. Two people who were pretending to be doctors. I got them both fired from their job and the doctor took my side, the actual doctor. One of the five doctors that are coming from Beaumont University Health System over there came over there and defended me and got them both removed from their job. So it doesn't hurt to speak out but then sometimes that can hurt you. And it did hurt me. It got me moved off the prison and got me moved all the way to Loretto. So getting visits all the way in Pennsylvania as opposed to getting visits from San Antonio to Beaumont was a whole lot harder for my family. I think I got one visit in the whole six years that I was there in prison and that was from my mom and dad. So I strongly urged people who were asking for help were behind bars to really, really listen to what they say. And I try my best to provide black and pink information to prisons because they need that. It's a great resource for everybody all over the nation. They have chapters in California, Iowa, Ohio, Arizona, Texas. This is the only one I'm representing that one and I'm pushing the issues on that. A lot of it has to do with letters coming from individuals who were in bars and behind their prison gates and they don't have any family to correspond with. So being a pen pal. They have a pen pal program that's really, really great. The art program is really good. The book program, everything that they provide is to help them better their time behind bars. I've been in the hole before and it's not beautiful.  I've seen it happen. It's not a nice thing to see and it really affects you for the rest of your life. You know, I don't think about it every day but it does affect you when certain instances come to view. My thing that I do out here in the community is I try to be a beacon of hope for a lot of people who are going to be in that position.  When I got there, I never cried the whole time I was there until I came home. I cried when I came home because everything was different. You know, I'm taking a bus all the way from Pennsylvania to San Antonio. I never slept the whole three days. I literally stayed awake looking out the window because I got a free trip across America on their bill. So I was very excited to do this and come home. So when I came home, I thought, you know what, I want my transgender individuals, my lesbian, gay, bisexual, transgender, all these individuals should really, really make a mark and make a point to show that we can do something to make it better for other people. And we're considered the little people and a lot of times we're considered not the norm. So we have to fight to be that norm and our community is very small here in San Antonio. It really, really is. And so what I try to do is, like I said, become that vegan hope and be that person who they can come to and ask for questions and say, like, I've got a family in the world like ours. What do I do? What are my resources here in San Antonio? Well, here's where you can go. This is what you can do. And sit down and talk. And it is a great thing to do. We need to have that, this type of things happening here in San Antonio more often where people can really come together and fight for everybody who needs that help. We don't have the family to fight for them. And so, like I said, I also own my own business. So being a business owner for almost a year now, it doesn't say that just because you're transgender, just because you've been behind bars, just because you've done all this, I think a lot more practical on issues because I did it. And if I can do it, other people can do it too. Just because you're here, no one place is where you're going to know somewhere else because I can provide those avenues for you to make that happen. It doesn't matter what you're doing, as long as you are doing the right thing and sometimes you're doing the right thing, you still get shot down. I've watched instances where a person who's trying to do the right thing gets shot down by an operation officer and then operation officer two weeks later, quit and went to another job. So this person who's really trying to do something good and they couldn't do it, you can do that.