PT  - JOURNAL ARTICLE
AU  - Zamir Merali
AU  - Armaan K. Malhotra
AU  - Michael Balas
AU  - Gianni R. Lorello
AU  - Alana Flexman
AU  - Tara Kiran
AU  - Christopher D. Witiw
TI  - Gender-based differences in physician payments within the fee-for-service system in Ontario: a retrospective, cross-sectional study
AID  - 10.1503/cmaj.210437
DP  - 2021 Oct 18
TA  - Canadian Medical Association Journal
PG  - E1584--E1591
VI  - 193
IP  - 41
4099  - http://www.cmaj.ca/content/193/41/E1584.short
4100  - http://www.cmaj.ca/content/193/41/E1584.full
SO  - CMAJ2021 Oct 18; 193
AB  - Background: Differences in physician income by gender have been described in numerous jurisdictions, but few studies have looked at a Canadian cohort with adjustment for confounders. In this study, we aimed to understand differences in fee-for-service payments to men and women physicians in Ontario.Methods: We conducted a cross-sectional analysis of all Ontario physicians who submitted claims to the Ontario Health Insurance Plan (OHIP) in 2017. For each physician, we gathered demographic information from the College of Physicians and Surgeons of Ontario registry. We compared differences in physician claims between men and women in the entire cohort and within each specialty using multivariable linear regressions, controlling for length of practice, specialty and practice location.Results: We identified a cohort of 30 167 physicians who submitted claims to OHIP in 2017, including 17 992 men and 12 175 women. When controlling for confounding variables in a linear mixed-effects regression model, annual physician claims were $93 930 (95% confidence interval $88 434 to $99 431) higher for men than for women. Women claimed 74% as much as men when adjusting for covariates. This discrepancy was present in nearly all specialty categories. Men claimed more than women throughout their careers, with the greatest gap 10–15 years into practice.Interpretation: We found a gender gap in fee-for-service claims in Ontario, with women claiming less than men overall and in nearly every specialty. Further work is required to understand the root causes of the gender pay gap.