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DIVERSITY Advancing Equity: The Role of Fair Compensation in Mitigating the Minority Tax Within Medical Academia

By: Ronscardy F. Mondesir, BA, Florida International University, Herbert Wertheim College of Medicine, Miami; Maria Uloko, MD, MUMD LLC Sexual Medicine Consulting, Los Angeles, California | Posted on: 19 Apr 2024

Diversity is not merely a requirement on our collective moral agenda; it is a paramount factor that propels organizations toward excellence. Extensive research consistently demonstrates that diverse workforces foster increased innovation, creativity, and problem-solving abilities.1-3 Research across various sectors, including medicine and industry, unequivocally demonstrates that diverse teams contribute significantly to enhanced creativity, decision-making, and overall performance.3,4 A seminal study by McKinsey & Company underscores this vital fact and shows that companies in the top quartile for ethnic and cultural diversity on their executive teams were 33% more likely to have industry-leading profitability.5

The term minority tax refers to the additional, often uncompensated responsibilities placed on employees of color, typically involving diversity, equity, and inclusion (DEI) initiatives.6 Coined within academic medicine, it encapsulates the undue burden that falls disproportionately on minority staff despite diversity efforts benefitting the greater collective. This can range from serving on diversity committees, mentoring other minorities, supporting other minority employees or students, and being the unofficial representative for their entire demographic group. This work is often done in addition to their clinical/academic duties with very limited resources, additional time, or funding. This can lead to a significant drain on time and energy, diverting attention from their primary professional responsibilities and opportunities for advancement.7 Additionally, the minority tax can contribute to feelings of isolation and the pressure to perform at higher standards than their nonminority counterparts, to counter stereotypes.8 This phenomenon counteracts the very essence of diversity efforts by imposing an unfair toll on those it aims to uplift, highlighting a paradox in institutional values toward diversity.

Despite widespread acknowledgment of the importance of DEI initiatives, the execution by academic institutions often falls short in valuing these roles in compensation. Individuals dedicated to DEI shoulder a unique burden, undertaking responsibilities that not only go unrecognized by their peers but also disproportionately benefit them. Often, the efforts of minoritized faculty and staff remain unpaid. When compensation is offered, it seldom matches the significant challenge of enacting comprehensive institutional reforms. Such an endeavor is no minor task; it involves dismantling long-standing oppressive structures and laying down the groundwork for a more inclusive environment.6 The undervaluation of DEI work becomes starkly apparent when compared to the compensation structures of other consulting services. Given that individuals involved in DEI bring specialized expertise, resources, and skills crucial for addressing and rectifying systemic issues within institutions, much like external consultants, it stands to reason that their compensation should be on par with that of a consulting firm.

Consulting firms, such as the globally recognized McKinsey Consulting, command fees that reflect the depth of expertise, strategic insight, and value they bring to their clients. These fees, as reported, range dramatically based on the nature of the engagement, with daily rates extending from $660 to over $13,000 for senior partners.9,10 This pricing structure is a testament to the significant impact these professionals make. McKinsey, renowned for its effectiveness and innovative solutions, sets a benchmark for how specialized knowledge is valued in the corporate world.

The juxtaposition of this model with the current state of compensation for DEI professionals in academia raises a critical question: why are we not valuing and compensating DEI efforts similarly? These individuals are tasked with navigating complex challenges, fostering inclusive environments, and driving systemic change within institutions. Their work is not ancillary but central to the mission and success of academic institutions. By undercompensating DEI efforts, we not only continue the harmful cycle of the minority tax but also signal a lack of genuine commitment to the principles of DEI.

To address this disparity, it is imperative that academic institutions begin treating DEI professionals as they would high-end consultants. This means recognizing the specialized knowledge, expertise, and insights they bring to their roles and ensuring they are justly compensated. If organizations genuinely valued DEI, the logic follows that they would allocate resources—including fair compensation—to those leading these efforts, akin to how they invest in external consultants for other organizational challenges. Fair compensation in this context goes beyond a standard salary; it must include additional remuneration that acknowledges the extra duties DEI professionals undertake—duties that often extend their work beyond traditional academic roles and encroach upon personal time.

Such a shift in compensation strategy is not merely about fairness; it’s about efficacy and sustainability. Fairly compensated DEI professionals are better positioned to dedicate themselves fully to their roles, innovate, and drive meaningful change. Moreover, this approach can serve as a model for other sectors, illustrating academia’s leadership in valuing diversity and inclusion not just in words but in tangible actions.

The path forward requires a reassessment of how DEI efforts are supported at institutions, which includes competitive compensation as well as time to be able to enact meaningful change. Such a shift would not only address the minority tax by acknowledging the true value of DEI professionals’ contributions but also incentivize more individuals to engage deeply with diversity work. Fair and competitive compensation could transform DEI from an undervalued task into a sought-after career path, attracting talent and dedication to the cause.

  1. Swartz TH, Palermo AS, Masur SK, Aberg JA. The science and value of diversity: closing the gaps in our understanding of inclusion and diversity. J Infect Dis. 2019;220(Suppl 2):S33-S41.
  2. Garg S, Sangwan S. Literature review on diversity and inclusion at workplace, 2010–2017. Vision. 2021;25(1):12-22.
  3. Gomez LE, Bernet P. Diversity improves performance and outcomes. J Natl Med Assoc. 2019;111(4):383-392.
  4. Khuntia J, Ning X, Cascio W, Stacey R. Valuing diversity and inclusion in health care to equip the workforce: survey study and pathway analysis. JMIR Form Res. 2022;6(5):e34808.
  5. Hunt DV, Yee L, Prince S, Dixon-Fyle S. Delivering through diversity. McKinsey & Company. January 18, 2018. Accessed February 7, 2024. https://www.mckinsey.com/capabilities/people-and-organizational-performance/our-insights/delivering-through-diversity
  6. Rodríguez JE, Campbell KM, Pololi LH. Addressing disparities in academic medicine: what of the minority tax?. BMC Med Educ. 2015;15(1):6.
  7. Campbell KM. Mitigating the isolation of minoritized faculty in academic medicine. J Gen Intern Med. 2023;38(7):1751-1755.
  8. Campbell KM, Rodríguez JE. Addressing the minority tax: perspectives from two diversity leaders on building minority faculty success in academic medicine. Acad Med. 2019;94(12):1854-1857.
  9. McIlroy T, Tadros E. Revealed: McKinsey partners charge $16,000 a day (before discounts). The Australian Financial Review. August 9, 2019. Accessed February 5, 2024. https://www.afr.com/politics/federal/revealed-mckinsey-partners-charge-16-000-a-day-before-discounts-20190808-p52f2a
  10. State of New Jersey: COVID-19 response—continued strategic and operational support (phase 3). McKinsey & Company. November 10, 2020. Accessed February 4, 2024. https://nj.gov/covid19oversight/transparency/contracts/pdfs/njsp_mckinseysupp.pdf

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