a recent study found a gender pay gap in Canada’s reproductive health system.
Doctors in eight provinces who perform genitourinary (reproductive and urological) procedures on female patients receive an average salary 28% less than those who perform similar surgeries on male patients.
Saskatchewan has the largest discrepancy of the eight provinces, at 67 percent, followed by BC at 61 percent and Yukon at 41 percent.
Joanne Sivertson, chief of the provincial department of Obstetrics and Gynecology (OB-GYN) in Saskatchewan, said the numbers are disappointing, even though she is insensitive to gender disparities.
“It’s degrading, it’s degrading to women,” she said.
As part of the study, which was published in the Canadian Journal of Surgery on July 4, the researchers looked at similar procedures performed on the male and female reproductive organs. For example, surgeons are paid more to biopsy male genitalia than female genitalia, even though it is essentially the same procedure.
Michael Chaikof, one of the study authors and an obstetrician-gynecologist-urogynecologist at Sunnybrook in Toronto, called it double discrimination.
“Not only are female surgeons paid less on average, but surgeons who care for women are also paid less,” Chaikof said. “If you look at our field of gynecology…the majority of surgeons in our specialty are women.”
Sivertson said this discrimination stems from historical policies. Caring for women has been undervalued for decades and pay increases are made by percentage, she said. Policymakers continue to perpetuate that under scrutiny and it will take a big correction to catch up with caring for men, Siverston said.
Sivertson said that when she was a medical student, an obstetrician-gynecologist who was her teacher made a comment that still disgusts her.
“He said it was a tragedy that only women were admitted to obstetrics and gynecology, because the profession would lose all credibility.”
He said it is unacceptable that such attitudes prevail to this day.
In some cases, a similar procedure will be more difficult or dangerous for a woman, but she will pay less. Sivertson mentioned a procedure in which an ovary or testis twists on itself and must be untwisted.
“To untwist an ovary you have to go into the abdominal cavity, so it’s a much riskier and more complex surgery, and you pay 50 percent less than you would to untwist a testicle.”
Sivertson said that recognizing these disparities is the first step in fixing them. She wants to see more resources put into caring for women.
“We continue to fight to provide basic health services to women in the province,” he said.
Chaikof said she hopes the study will prompt provincial medical associations to look at their fee schedules through a gender equity lens and empower surgeons to go to governments and advocate for gender equality.
Dr. Annette Epp, president of the Saskatchewan Medical Association (SMA), said that once a procedure’s fee is set low, it’s hard to catch up.
“It is unfortunate and certainly unacceptable that Saskatchewan is falling further behind in this country. But in terms of how fee structures happen, it’s a pretty complicated process,” Epp said.
She said that the SMA plans to approach the issue and discuss the disparity through a gender equality lens.
“I would say it sends a message that maybe women’s health is not valued as highly and that needs to change,” Epp said. “I think as a society and as a profession we need to recognize that there are disparities in outcomes between women and men, and that needs to be corrected.”
The Saskatchewan Ministry of Health sent the CBC a statement in response to an interview request.
“Doctors bill the government directly for each insured service they provide (eg, physical examination, surgery, immunization) according to the approved payment schedule,” the ministry statement read.
“The ministry and the Saskatchewan Medical Association are working to modernize the payment schedule to ensure consistent, equitable and appropriate payments to physicians for the provision of insured health services.”
