Happy Canadian Women Physicians Day!
Today is the second annual Canadian Women Physicians Day! Our newsletter today is all about women in medicine, to show our gratitude, to consider how far we’ve come, and how far we still have to go. We also have a special announcement about an important improvement we are making to our Retention Benefit Program to be more inclusive and more fully support physicians taking maternal/parental leave.
March 11 was selected to celebrate Canadian Women Physicians to honour the first woman licensed to practice in Canada, Dr. Jennie Trout, who received her medical license on this day in 1875. It follows International Women’s Day, held on March 8.
Physician Retention Benefit and Maternal/Parental Leave
We are pleased to announce today that Doctors Manitoba is updating the eligibility criteria under our Physician Retention Benefit. The change will ensure members who take time away from their practice during maternity or parental leave, and then continue to practice here in Manitoba, do not miss out on a share in the Retention Program.
Retention shares are earned annually for continued practice in Manitoba and paid out every five years. Under the original eligibility rules for the Retention Program, some members – primarily women – can lose a half or full share in the Retention Program depending on the timing of their baby’s delivery. This could mean a loss of $3,000 for a full year share at today’s rate, for example, in benefits paid out from the program. That sends a signal that can undermine the goal of the benefit program, to retain physicians in Manitoba.
Earlier this week, the Board of Directors unanimously supported a change to the program eligibility criteria that will mean any member who continues to practice in Manitoba until their next five-year milestone will not lose a share or half share under the program due to maternal/parental leave. To be clear, this means time away from your practice for parental leave will no longer result in a reduced benefit under our Retention Benefit.
The Board also approved applying this change retroactively, which means members who lost full or half shares due to a maternal/parental leave in the past will receive their share, plus interest. Since the program was introduced in 2003, we estimate that over 100 of our current members may have lost a portion of their benefits under this program due to a maternal/parental leave.
Manitoba Health also supports making this change, which is important as we require their approval to make any changes to the criteria. The original criteria were established when the program was designed in 2002. The improved and more inclusive criteria will not result in a reduction of share values or benefits for any other members.
Over the coming weeks, our team will be identifying members who missed a full or partial change due to maternal/parental leave and we will contact you directly. We will notify all members when this process is complete, which will also serve to notify any members we may miss to contact us about their situation. Should you have any questions in the meantime, please contact Barry Hallman, our Benefits Coordinator at firstname.lastname@example.org.
How Far We’ve Come, How Far We Have to Go
Twenty years ago, only 26% of physicians in Manitoba were women. Today, they make up nearly 40%. This is a significant improvement over two decades, especially when looking at younger physicians. Among resident physicians and medical students, about half are women.
Women have also been assuming medical leadership roles too. Dr. Sri Navaratnam is the CEO at CancerCare. Dr. Deb Mabin has been CMO of the Interlake-Eastern and Northern RHAs. Dr. Ainslie Mihalchuk was the first woman CMO in the WRHA. She now works in a leadership role at CPSM, along Dr. Anna Ziomek who leads the organization as Registrar and CEO. Of course, Dr. Joss Reimer and Dr. Marcia Anderson played key leadership roles during the pandemic response. These are just some of the many women who are taking on medical leadership roles across the health system.
Despite this progress, inequities remain and the profession is far from inclusive.
In our annual member survey last month, 47% of women physicians reported being mistreated by colleagues and 43% by leadership. These rates are three times higher than those reported by male physicians, and they are even higher among women who identify as Black, Indigenous or a Person of Colour (BIPOC).
That same survey found that women identified significant inequities in many areas:
• 53% reported inequities in recruitment opportunities
• 64% reported inequities in medical leadership
• 47% reported inequities in remuneration
These rates were more than double those reported by their male colleagues.
Our preliminary analysis of 2020/21 physician remuneration in Manitoba found a pay gap of 31% between male and female physicians. On average, women make less than men in nearly every physician bloc, including areas that are dominated by women such as pediatrics, obstetrics and gynecology.
While this is a preliminary review and requires a much deeper analysis to better understand the issue and its causes, the gap is large enough that it is clear there is a problem.
And Manitoba is not alone.
Studies from several other jurisdictions have found pay gaps between male and female physicians as well. An American study published earlier this year found that even after controlling for number of clinical hours worked, a significant pay gap remained. An Ontario study published last year in JAMA found women physicians earned 33% less than their male counterparts. Even after controlling for possible explanations, such as practice characteristics, geography and specialty, and days worked, a significant 13.5% pay gap remained. Another Canadian study in CMAJ concluded the “gender pay gap in medicine is not explained by women working fewer hours or less efficiently but, rather, relates to systemic bias in medical school, hiring, promotion, clinical care arrangements, the fee schedule itself and societal structures more broadly.”
Dr. Kristjan Thompson, President of Doctors Manitoba, acknowledges that this is data that can’t be ignored. “It should come as no surprise that physicians in Manitoba experience the same bias, the same inequities, and the same barriers as their colleagues in other provinces and countries. As a profession that is guided by evidence in all we do, we must follow this data to understand the root causes, and we must act to break the bias. When all physicians can thrive equally, all physicians will benefit exponentially.”
What is Doctors Manitoba Doing?
In addition to surveying our members for the views on gender inequities, and analyzing remuneration data, we’ve been focusing on addressing gender inequities in several ways.
Our new strategic plan reflects a more inclusive approach to strengthening and supporting the whole physician. From correcting missed disability insurance claims related to child birth, to now repaying shares under our Retention Benefit missed due to maternal/parental leave, we are reviewing our programs and services and responding to concerns from members to ensure our criteria and practices are equitable and inclusive.
Gender equity is also a strong theme in the bloc working groups, identifying issues and priorities for negotiating the next Master Agreement. We’re also looking for external research expertise to help us further analyze the pay gap between men and women in the profession to better understand the root causes and how to address them.
When it comes to women in medical leadership, Doctors Manitoba has been a supporting partner in a Women in Leadership Coaching pilot, co-led with Dr. Marcia Anderson and Dr. Gigi Osler. Our goal is to support leadership development for women physicians while developing this program through this important pilot.
At a governance level, the Doctors Manitoba Board finally achieved gender parity just last year, with 11 women on the 21-member Board, a significant change from a decade ago when there were only three women on the Board. In 2018, Doctors Manitoba hired its first woman CEO, Ms. Theresa Oswald, and later this year, Dr. Candace Bradshaw will take the reigns as President of Doctors Manitoba.
“As doctors, we embrace health equity as a guiding principle in how we meet the needs of our patients, but it’s clear there is much more work to do within our profession when it comes to the intersections of gender, race and other personal attributes that lead to inequities and discrimination,” said Dr. Bradshaw. “I believe our profession is in a period of transformation, moving towards a more inclusive medical community where all physicians can practice to their full potential, free from harassment or bias. That transformation will be good for all physicians, and for our patients, but it won’t happen without a collective and relentless approach.”
With more women in decision-making roles, better and more inclusive decisions are made that benefit all members. We welcome your insights and advice along the way. Please contact Trina Larsen, our Director of Policy and Planning, at email@example.com.
Canadian Women Physicians Day Celebrations This Week
Live Event Tonight
Canadian Women in Medicine is hosting a special virtual event this evening (Friday) at 7PM. This event is open to physicians of all genders. They will discuss the challenges of the past two years, celebrate our strength and resilience, and consider opportunities for moving forward from the pandemic and creating meaningful change instead of merely returning to “normal”.
Speakers include Dr. Aimée Bouka, Dr. Dairy Fung, Dr. Courtney Howard and Dr. Lisa Richardson. The evening will also feature musical performances from four members of Voices Rock Medicine 60-voice choir, Dr Irene Chen, Dr Mariella Ferreyra, Dr Monidipa Ravi, and Dr Christine Song; and the Calgary Physicians Choir.
Register now to get credentials to join in advance. You can register here.
Stream Recording from Tuesday
On Tuesday, International Women’s Day, the Federation of Medical Women in Canada hosted a panel discussion called Breaking Barriers and Leading Change. You can now stream the event on demand by visiting the FMW website.
Future is Female: CMA President
Canadian Medical Association President Dr. Katharine Smart published a must-read opinion article this week in the Globe and Mail. Take a few minutes this weekend to read The medical world is failing the very women who are trying to hold it together. As Dr. Smart explains, the future of medicine looks female, but the culture needs to catch up.