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News release
Aug. 25, 2023

OMA research finds male specialists get more referrals, higher billings

TORONTO, Aug. 25, 2023—A centralized referral system where primary care physicians could send patients to specialists with the shortest wait times might help narrow the gender pay gap between male and female physicians, according to research by the Ontario Medical Association.

Research published today in the journal JAMA found that male specialists got disproportionately more referrals than female specialists and earned almost 5 per cent more for each referral.

“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,” said OMA President Dr. Andrew Park. “This kind of research provides valuable evidence on which to build solutions.”

The OMA 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 2018-19. Female specialists earned 4.7 per cent less per referral than males.

The research found 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 for each patient.

The researchers said this gap will likely remain unless there are policy changes and that it creates a vicious cycle, with female specialists having fewer opportunities to perform procedures and acquire skills.

One solution would be to create a gender-blind, centralized referral system. Being transparent about individual specialists’ wait times may help female doctors who are thought to have shorter wait lists than men because of referral biases.

As part of its proposals to improve the health-care system, the OMA has already recommended creation of a centralized wait list and referral system in each of the six Ontario health regions for certain surgeries and procedures.

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 practicing at the same hospital.

“Our study found the gender pay gap among specialists was due both to the number of referrals to male specialists and the higher billings that resulted,” said Dr. Lyn Sibley, director of the OMA’s Healthcare Evaluative Research department. “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. Sibley, who has a PhD in health services research and was one of the paper’s authors.

About the OMA

The Ontario Medical Association represents Ontario’s 43,000-plus physicians, medical students and retired physicians, advocating for and supporting doctors while strengthening the leadership role of doctors in caring for patients. Our vision is to be the trusted voice in transforming Ontario’s health-care system.

For more information, please contact:

Leslie Shepherd
Director, Earned and Social Media
Ontario Medical Association