The Ontario Medical Association says it has identified a significant pay gap between male and female doctors.
In the largest study of its type in Canada, the OMA examined Ontario Hospital Insurance Plan billings from 2017-18 adjusted for factors such as years of experience and work outside of business hours and found there is an unexplained gap of 15.6 per cent in pay.
“The gender pay gap is an unfortunate reality that crosses all sectors,” says OMA Chief Executive Officer Allan O’Dette. “With this report we can start to address how it impacts physicians. Hopefully, this work will lead to better equity not only for doctors but for all women.”
Significant variations in the billings gap were identified across specialty, geography and practice setting (private vs. hospital). The report says the unexplained gap was the highest among general and family practice physicians at 19 per cent and lowest among surgeons at 10.2 per cent. The gap was highest in a semi-urban setting (19.8 per cent), and lowest in rural settings (10.1 per cent) with urban landing in the middle (13.5%).
“Pay equity is essential to ensuring that we have a diverse medical profession,” says OMA President Dr. Samantha Hill. “We have seen in many sectors that there are huge benefits to end users when there is increased diversity. It would follow that patient outcomes will be improved by diversity in their physicians.”
The OMA says more study is needed into the causes of the gap as well as potential solutions. Possible explanation that have been identified during physician consultations include, patient characteristics, referral networks, fee codes and coding practices, mix of services and factors reflecting societal gender-biased expectations and systemic discrimination.
The study includes four recommendations for the OMA:
1. Lead a reform of the schedule of benefits
The OMA should take a leadership role to revise the schedule to better reflect the work required to perform each service. Revisions should be considered through a gender lens to ensure that all physicians and patients are advantaged equally.
2. Advocate for pay equity
The OMA should launch an advocacy campaign directed toward health system partners to raise awareness about the gender pay/billing gap in medicine. The campaign could promote fair and equitable career advancement in medicine and institutional policies that promote equal pay for equal work.
3. Advocate for expanding opportunities for female physicians
The OMA should work to expand opportunities for female physicians (e.g., leadership development and networking opportunities) and medical learners (e.g., mentorship opportunities and career planning). The OMA should take steps to ensure female learners are not subjected to a hidden curriculum of inherent bias.
4. Advocate for improved benefits for Ontario physicians
The OMA should advocate for access to benefits and supports similar to those enjoyed by other professionals (e.g., improved parental benefits would lessen financial burden associated with family formation and would benefit both male and female physicians).
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Seeking equality of outcome without understanding the reasons disparity exists is likely to be a failure. The presence of disparity is a feature of society, not a bug. It is impossible to eliminate it.
By all means apply research and science to the problem… but don’t assume the etiology just because disparity exists.
It seems that attempts to revise the fee schedule (to better reflect time and skill) have been ongoing and largely, a failure.
Lastly, the assumption that individual physician choice is not the prime driver, is typical in this victim-oppressor, critical-theory driven worldview that has seized society. Everywhere critical theory is applied, discord and conflict escalates.
Attempts to equalize the outcome of income as (opposed to opportunity) is likely no different.