New research from the Ontario Medical Association has found male specialists get more referrals and higher billings, leading to a noticeable gender pay gap between male and female physicians.
Research published by the association found that male specialists earned almost five per cent more for each referral and disproportionately more referrals than their female counterparts.
“The fact that the gender pay gap in medicine remains so many years after it was first identified is worrying, especially as more than 40 per cent of physicians in Canada are women,” OMA president Dr. Andrew Park said.
“I think what it reflects is that we have some definite unconscious bias in the way we practise medicine, and that has implications both for our physician colleagues and our patients. I think it’s really important to have frank conversations about where we have those biases and where we can therefore work to create a more equitable playing field for women coming into this field.”
The association looked at OHIP billing data for 7.6 million new referrals made by 32,824 physicians to 13,582 surgeons and other specialists in Ontario in 2018 and 2019.
Researchers found that physicians were more likely to refer to specialists of the same gender, but physicians of both genders referred more patients to male specialists, impacting the total number of referrals and therefore payment.
“We found that 83 per cent of the difference was due to the greater number of referrals and 17 per cent to the higher billings,” said Dr. Lyn Sibley, director of the OMA’s Healthcare Evaluative Research department.
The researchers warn this gap will likely remain unless there are policy changes that allow female specialists to have more opportunities to perform procedures and acquire skills.
What could help close the gap
Park says with more women physicians graduating from medical school than men, it’s important to look at how to address this issue now.
“This really bodes for the future of our profession to say this is not something that should be happening and it’s something that we’re invested in researching and understanding the solutions that are required to close this gap.”
Park notes that through this research they can work toward building solutions and addressing inefficiencies in the system through steps such as a gender-blind, centralized referral system.
The association says a system like this would make it so primary care physicians could send patients to specialists with the shortest wait times, which might help narrow the gender pay gap since female doctors are thought to have shorter wait lists than men because of referral biases.
The study found that while referring physicians had 6.6 per cent higher odds of referring to specialists of the same gender, they were also more likely to refer to specialists with similar years of experience and those practising at the same hospital.
“Instead of saying I want this surgeon to do X, I’m really saying my patient needs Y, and then it goes into the queue, and then the next available surgeon, specialist, cardiologist, internal medicine specialist, that is able to see those needs is brought forward as opposed to saying it’s Dr. X. Because I have no idea what Dr. X’s wait times are, I have no idea what his or her capabilities are within this area and that’s why oftentimes there’s big delays,” Park says.
As part of its proposals to improve the health-care system, the association says it has already recommended the creation of a centralized wait-list and referral system in each of the six Ontario health regions for certain surgeries and procedures.
In a statement, the Ministry of Health says the government is “continuing to work with healthcare partners, including the Ontario Medical Association, on innovative solutions that will make it easier for Ontarians to access the healthcare system, by providing more convenient to access the care they need, when they need it.”
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