Adding fuel to the doctor crisis
Five million Canadians are currently without a family doctor-and things are only getting worse
CATHY GULLI AND KATE LUNAU | Jan 2, 2008 | 17:23:34
That’s all fine, of course, for those patients who can get an appointment. “How about all those poor sods who don’t have a family physician at all?” implores Baker. Or those who lose their doctor earlier than they expect. While little data exists on the retirement patterns of physicians, one CMA study suggests the average female doctor retires at 58—10 years before males in the same profession. Baker says his wife was recently dumped by her own doctor. “She sent out a letter to her patients saying she was resigning. She’s [only] in her early 40s,” he recalls. “She wanted to spend more time with her kids. You can’t argue with that.”
Not only will finding a family physician become increasingly difficult as more women opt out of medicine, but in the future, patients could struggle to find specialists, too. CIHI figures show that just 31 per cent of medical specialists are female, compared with 47 per cent for family doctors. Some fields—including pediatrics, dermatology, and geriatrics, where roughly 50 per cent of physicians are female—do attract more women. But they continue to avoid some of the most important areas of medicine, such as the surgical specialties, where only 19 per cent are female. In other words, the increasing proportion of women in medical school could lead to a severe shortage of surgeons down the road.
Family medicine appeals to women because of its perceived flexibility of hours and the chance to bond with patients over many years, explains Dr. Ruth Wilson, president of the College of Family Physicians of Canada (CFPC). But the difference in pay is significant—in the 2004-2005 fiscal year, the average gross pay of a family doctor was $202,219 (before overhead costs, which can eat up as much as 40 per cent), compared with $269,606 for specialists. Surgeons, who are overwhelmingly male, are on the high end of the pay spectrum—they average $347,720 a year.
The situation is critical in the boom town of Calgary, where escalating overhead costs are driving doctors out of business. In the last year, as thousands of new residents flooded into the city, at least 41 family physicians abandoned their practices. Dr. Linda Slocombe is one of them—she closed up in December 2006. “The only way you can fight increasing overhead is to increase the number of patients you see,” says Slocombe, 52, president-elect of the Calgary and Area Physician’s Association. “It was too stressful. I didn’t want to have to keep seeing more patients, faster, in a day.”
In Digby, locals are hoping that their female physician isn’t gone for good. “With maternity leave there’s always the hope that she’s coming back,” says Tideview’s Boudreau. But “rumour is that she’s not,” she admits.
Before she went on maternity leave last September, family physician Dr. Kathy Lawrence would start her workday at 7 a.m., put in 55 hours a week (not including on-call time), and often spend her evenings and weekends doing research and paperwork—she’s also a full-time professor at the University of Saskatchewan. Now a single mother with a baby at home, Lawrence, 38, is a few months into her one-year hiatus. After that she’ll be back to working full-tilt. Long hours, Lawrence believes, are part of a doctor’s job description: “Becoming a physician means you’ve made a commitment,” she insists. “We’re a caring profession, and sometimes that means putting patients first.”
If not, medicine is threatened with becoming a “pink ghetto,” experts worry. Because women work less, they might avoid taking on leadership roles in the profession, and won’t be taken seriously as policy-makers as a result. “When it’s a male-predominant profession, society perks up its ears and pays attention,” says Dr. Shelley Ross, secretary-general of the Medical Women’s International Association. But the way things are going, women doctors “run the risk of losing influence, losing value, [and the] ability to influence where dollars go.”
The choice to pull away from work has also delayed professional advancement for many female physicians. Dr. Maria Goodridge, 44, knows about this first-hand. Like her husband, she’s a family doctor; and like her husband, she’s a faculty member at Newfoundland’s Memorial University. Since the couple’s youngest daughter was born, Goodridge has kept part-time hours to be closer to their four kids. Her husband, Dr. Scott Moffatt, works up to 50 hours a week—about five times as much as his wife. While Moffatt has risen through the ranks (he was promoted to undergraduate director of family medicine in September), Goodridge’s own career has languished. She has no regrets. “Because I’ve cut back my hours so much, I’ve not advanced to any great extent,” Goodridge says. “But that was a choice I made.”