• Zamir Merali, Armaan K Malhotra, Michael Balas, Gianni R Lorello, Alana Flexman, Tara Kiran, and Christopher D Witiw.
• Division of Neurosurgery (Merali, Malhotra, Balas), Department of Surgery, and Department of Anesthesiology and Pain Medicine (Lorello), University of Toronto; Department of Anesthesia and Pain Medicine (Lorello), Toronto Western Hospital - University Health Network, Toronto, Ont.; Department of Anesthesiology, Pharmacology, and Therapeutics (Flexman), University of British Columbia, Vancouver, BC; Department of Family and Community Medicine (Kiran), St. Michael's Hospital, University of Toronto; Institute of Health Policy, Management and Evaluation (Kiran, Witiw), University of Toronto; Division of Neurosurgery (Witiw), Department of Surgery, University of Toronto, St Michael's Hospital, Toronto, Ont.
• CMAJ. 2021 Oct 18; 193 (41): E1584-E1591.

BackgroundDifferences 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.MethodsWe 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.ResultsWe 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.InterpretationWe 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.© 2021 CMA Joule Inc. or its licensors.

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