The gaps range from 33 to 218 per cent, and the association of Quebec OB-GYNs says there is no medical reason to justify the difference.
Some medical procedures performed on women are significantly less well paid than their equivalent for men, according to a new study conducted on behalf of the Association of Obstetricians and Gynecologists of Quebec (AOGQ).
The gaps documented by the firm Raymond Chabot Grant Thornton vary from 33 per cent to 218 per cent, while according to the AOGQ, there is no medical reason to justify it.
But it’s not just a question of dollars and cents, AOGQ vice-president Dr. Liliane Brassard said.
“I think Quebecers have the right to know that the value given to care given to a woman is lower than that given to care given to a man,” she said. “That’s the message we’re sending. It’s the basic principle of equity, of women’s health care. That is our biggest message.”
Some of the examples provided are striking.
For example, the radiation treatment brachytherapy of the uterus is paid at $82.70, compared with $262.60 for brachytherapy of the prostate, a difference of 218 per cent. The difference between brachytherapy of the cervix and brachytherapy of the prostate is 167 per cent.
An egg retrieval for in vitro fertilization is paid at $369.45, but a sperm retrieval for the same purpose is paid at $949.95, a difference of 157 per cent.
“It is a similar procedure, for the same treatment,” Brassard said. “There is no medical explanation. We cannot say that it is more complex. There is no distinction at the medical level.”
Finally, an endovaginal pelvic ultrasound is paid at $27.25, compared with $66.25 for a transrectal ultrasound, a difference of 143 per cent.
The smallest difference measured is 33 per cent, for opening and drainage of an abscess of the vulva or glands vs. the same procedure for an intrascrotal abscess.
“What I find most concerning is the message we are sending about women’s health,” Brassard said. “But we can certainly wonder if this could increase the shortage of obstetricians-gynecologists.”
A medical student will base their choice of specialty on several factors. The figures used in the study are in the public domain and accessible to all.
And this is in addition to the “specific issues” that obstetricians-gynecologists face, Brassard said.
“I won’t hide from you that we are the ones who work the most unfavourable hours. We are woken up during deliveries, we are in the hospital at night, we work hard, we get up early in the morning. But it is certain that if this inequity continues over time, one of the perverse effects is that it can make us less interesting as a specialty to choose.”
The AOGQ published the figures as the Fédération des médecins spécialistes du Québec continues an equity exercise started in 2022 to review the relative value of medical acts. Results are expected in 2025.