Fe­male sur­geons earn 24% less, study finds

Au­thors, who used OHIP data from 2014 to 2016, say re­search shows ‘sys­tem’s kind of rigged against them’

The Peterborough Examiner - - CANADA & WORLD - PAOLA LORIGGIO

TORONTO — A new study shows fe­male sur­geons in On­tario earn less per hour than their male peers, de­spite the prov­ince’s clearly de­fined fee-for-ser­vice sys­tem.

The study, pub­lished to­day in the med­i­cal jour­nal JAMA Surgery, an­a­lyzed data from more than 1.5 mil­lion sur­gi­cal pro­ce­dures claimed by 3,275 On­tario sur­geons from the start of 2014 through 2016.

It found that over­all, women make 24 per cent less per hour while op­er­at­ing, a gap linked to the types of surg­eries they typ­i­cally per­form. The re­search found women per­form far fewer of the high­est-paid pri­mary pro­ce­dures, and are of­ten driven to­ward less lu­cra­tive spe­cial­iza­tions.

Two of the study’s au­thors, sur­geons at Toronto’s St. Michael’s Hos­pi­tal, say it dis­pels the idea a fee-for-ser­vice sys­tem such as the On­tario Health In­sur­ance Pro­gram elim­i­nates gen­der dis­par­i­ties in pay.

Dr. Fahima Dossa and Dr. Nancy Bax­ter say it also de­bunks the hy­poth­e­sis that fe­male sur­geons may be earn­ing less be­cause they work shorter hours or less ef­fi­ciently.

“Every­one’s al­ways try­ing to ex­plain gen­der dif­fer­ences by pathol­o­giz­ing women ... ‘There’s some­thing wrong with women, there’s some­thing about the way women work or the way they ne­go­ti­ate or the way they be­have in their space,’ in­stead of say­ing that the sys­tem’s kind of rigged against them,” Bax­ter said.

“What we were try­ing to do is de­con­struct many of the ar­gu­ments and say, ‘No, women are op­er­at­ing as quickly as men are, yet ... they end up mak­ing less per hour.’”

The pay gap per­sisted even af­ter the re­searchers ad­justed for spe­cialty: the largest mean dif­fer­ences were in car­dio­tho­racic surgery, where there was a dis­crep­ancy of $79.23 per hour, and or­tho­pe­dic surgery, where the gap was $73.66.

Male sur­geons also earned more hourly than fe­male sur­geons in gy­ne­col­ogy, even though there are more women in that field, the study found. The mean dif­fer­ence there amounted to $22.90 per hour. When the 200 most common pro­ce­dures were an­a­lyzed based on earn­ings per hour, the re­searchers found fe­male sur­geons per­formed more than a quar­ter of the least lu­cra­tive ones but less than six per cent of the high­est-paid ones.

The pro­por­tion of women per­form­ing an op­er­a­tion dropped as the pay per hour for that pro­ce­dure in­creased, the study shows. The doc­tors say the dearth of women in cer­tain sur­gi­cal spe­cial­ties limited some as­pects of the re­search.

The study also doesn’t go into why women don’t have the op­por­tu­nity to per­form high­er­pay­ing surg­eries, and Bax­ter and Dossa say that’s some­thing they would like to ex­am­ine in the fu­ture. Bi­ases in the feeset­ting and re­fer­ral pro­cesses likely play a role, Bax­ter said.

“When you look at who sets the fee codes for var­i­ous pro­ce­dures, in gen­eral, there aren’t a lot of women at those ta­bles. So you have men that are set­ting the fee codes that af­fect ev­ery­body,” she said.

It can be hard to find sur­geons will­ing to ac­cept re­fer­rals for pro­ce­dures that don’t pay well for the time re­quired, which means women — who get fewer re­fer­rals to be­gin with — end up tak­ing them on, she said.

“They’ll have to take the cases that other peo­ple turn down,” she said.

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