New research suggests “surgical sexism” is baked into the Canadian health-care system, revealing surgeons are paid less for procedures on female patients than they are for comparable surgeries on male patients.
The Toronto-based study, published in the Canadian Journal of Surgery earlier this month, found doctors are compensated on average 28 per cent less for operations on female patients than they are for similar procedures performed on male patients.
“The overarching message when we hear about studies like this is that society or the Ministry of Health doesn’t value women’s health to the degree that it should,” Dr. Andrea Simpson, an OB/GYN at St. Michael’s Hospital, told CTV News Toronto.
For the study, Sunnybrook Hospital OB/GYN Dr. Michael Chaikof said his research group created a list of common procedures performed exclusively on female patients and paired it with equivalent surgeries for patients with a male reproductive anatomy.
Then, they collected data on how much doctors were paid for these procedures in eight provinces and compared the lists.
The result: doctors performing surgeries on female patients made nearly $44 less per procedure than they did on male patients.
For example, a surgeon is paid over 50 per cent more for untwisting a testicle than for untwisting an ovary, despite the latter requiring a more technical internal procedure.
“There is nowhere in Canada where you earn more for operating on a female patient than a male patient,” Chaikof said.
The average reimbursement difference for all paired procedures in each province or territory (Surgical Sexism in Canada).
Of the eight provinces, the largest discrepancy was found in Saskatchewan where doctors are paid 67 per cent less for procedures on female patients, followed by 61 per cent in British Columbia. There was a “smaller but still significant difference” in Ontario where there was a 24 per cent discrepancy.
In prior research, Simpson and colleagues found female surgeons in Ontario earned 24 per cent less per hour – equivalent to $70 – on operating than male surgeons.
The new study found “double discrimination” comes into play when this disparity in earnings is layered on top of the fact that most surgeons in obstetrics and gynecology are women.
“This research basically proves there is a second layer of a pay gap based on the sex of their patients,” Chaikof explained. “They are earning less not only because they are women but because they are looking after primarily women.”
Further research is required to unpack the underlying biases that historically shaped these decisions, he noted. However, Chaikof said he suspects overt sexism and a devaluation of the female body played a role in the province’s decision-making decades ago.
CTV News Toronto reached out to the Ministry of Health on multiple occasions for this story but received no response.
Dr. Lesley Barron, a former Ontario Medical Association member involved in negotiating physician compensation with the provincial government, said this “structural sexism” has an adverse outcome for female patients. “As long as you have female clinicians caring for female patients, your work will be devalued,” she said.
Barron, who is now a medical director of surgical services in Australia, said the discrimination outlined by this study is not exclusively taking place in Canada.
“Sexism is everywhere no matter where you go.” she said.
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