What Are We Worth? An SGO Analysis of Compensation Structures That Measure and Value Work in Academic Gynecologic Oncology Practices
A new study published in Gynecologic Oncology examines one of the most complex and often poorly understood aspects of academic medicine: how compensation structures shape the careers of gynecologic oncologists. The research, led by Margaret Liang, MD, MSHPM, Co-Chair of the SGO Quality Care Committee, uncovers persistent challenges in how clinical work, teaching, and research are valued and offers insights into how the field might better support its workforce.
Why This Work Matters Now
For gynecologic oncologists, the demands of clinical care, academic scholarship, and education are tightly intertwined. Yet, the systems used to compensate these contributions often emphasize revenue-generating procedures while undervaluing the equally essential roles of mentorship, research, and advocacy.
“The SGO Quality Care Committee recognized that this is a topic that impacts gynecologic oncologists at all career stages,” Dr. Liang explained. “We are affected by the compensation structures and incentives that are in place for clinical care, research, and education in our practices every day, whether we fully understand or are in control of these structures.”
With physician burnout at record levels and academic institutions struggling to retain faculty, the study arrives at a critical moment. By mapping out how compensation may influence job satisfaction and retention, Dr. Liang and colleagues are contributing to a broader conversation about the sustainability of the specialty.
The Tension Between Clinical and Academic Work
One of the central findings of the study is the persistent tension between clinical productivity and academic contributions. Clinical care is essential to both patients and institutions, and it is often the primary driver of compensation. Non-clinical academic efforts such as publishing research, mentoring trainees, and building quality programs, can be harder to quantify and reward.
This contrast not only affects career satisfaction but also has long-term consequences for the field. When academic work is undervalued, institutions risk discouraging the very scholarship and innovation that advance patient care.
“Compensation systems should reflect the reality that research and teaching are not secondary to clinical care, but rather integral to the advancement of our specialty,” Dr. Liang emphasized.
Addressing Inequities in Reimbursement
The manuscript also highlights disparities in wRVU (work relative value unit) reimbursement, particularly in procedures involving female patients. These inequities are more than just a financial concern—they reflect how women’s health is systemically undervalued within medicine.
“When procedures that predominantly affect women are reimbursed at lower rates, it sends a message about what the system considers ‘worthwhile,’” Dr. Liang noted. This imbalance can erode morale among providers and perpetuate gender-based inequities in healthcare delivery.
Addressing these disparities requires action on multiple levels: institutional policies that prioritize equity, and broader advocacy to reform reimbursement systems at the national level.
Innovative Strategies to Recognize Academic Value
Despite the challenges, the study points to several strategies that institutions are using to better steady the scales. Among the most promising are academic scorecards and chair discretionary funds.
“Academic scorecards and chair discretionary funds are tools that more institutions are using to ascribe value and potentially reward these either non-revenue-generating or less revenue-generating activities that are vital to the academic mission,” Dr. Liang shared.
These approaches allow leaders to acknowledge the impact of non-clinical work, whether it’s time spent mentoring a fellow, designing a clinical trial, or contributing to professional societies. By scaling such models across institutions, academic medicine could take meaningful steps toward more equitable compensation frameworks.
A Call to Advocacy and Action
While no single solution exists, Dr. Liang stressed the importance of collective advocacy and cultural change. “This is not an easy issue to solve, as the business of medicine places a lot of pressure on practices and providers,” she said. “But the more SGO members and leaders can openly advocate for our value in each of these domains, the more we can ensure the sustainability of our profession by improving retention and career satisfaction while decreasing burnout.”
The stakes are high, and without intentional action, academic gynecologic oncology risks losing talented physicians to burnout or attrition; however, with greater transparency, institutional innovation, and member-led advocacy, the field can foster an environment where clinical excellence and academic contributions are equally valued.
Looking Ahead
Ultimately, the study highlights both the urgency of reform and the potential for progress. It calls on institutions to rethink how they define value and challenges the field to align compensation with its mission: advancing patient care through innovation, research, and education.