Comment: Access to health care is not a gender issue

According to the 2017 Commonwealth Fund report, wait times for Canadian health care are too long. Canada ranked third to last in health-care system performance and second to last for access to care in this comparison of high-income countries.

Despite physicians working longer hours than ever, patients still wait too long in our emergency rooms or too long for community support and care.

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Stories on access seem to be multiplying, and many Canadian doctors are collectively trying to identify solutions. We all suffer when our health-care system fails patients.

Sixty years ago, the medical profession was dominated by men — 93 per cent of physicians were male. In 2017, these stats have changed tremendously and reflect the progress we have made as a society. Today, 41 per cent of all Canadian doctors are women.

The 2017 CMA Workforce Survey revealed that female physicians work an average of 48 hours per week. According to StatCan, the average working week for an employed woman in Canada is 35.5 hours. In fact, both male and female physicians are working more hours compared to the last CMA Workforce Survey in 2014.

In addition to these regular work hours, most physicians also have on-call duties; for example on top of the 48-hour work week, female physicians spend an average of 104 hours per month performing on-call duties.

A study by StatCan reveals that while working women might work fewer hours than men, we have more responsibilities outside of traditional “work,” and spend more time on things such as house work and child care.

Recently, two studies emanating from the University of British Columbia suggest physicians — especially female physicians — are part of the ever-growing access problems. How exactly?

The studies state that female doctors either see fewer patients and work fewer hours, or choose to retire earlier than their male colleagues.

As a female physician, I had a strong and immediate reaction to the implication that worsening patient access is related to the increasing numbers of women in medicine.

It is too simplistic to suggest that the growing number of female physicians in Canada impedes the effective delivery of primary care. The reality is that our current health-care system is not responding and adapting to our growing numbers of complex patient populations.

Simply measuring the volume of patients seen by doctors undervalues the complexity of modern medicine and the care provided during a full patient-doctor visit.

In fact, a 2007 study by the Groupe de recherche interdisciplinaire en santé from the Université de Montréal showed that while they saw fewer patients per hour in their practice, women doctors spent a little more time with each patient, translating to greater patient satisfaction and an increase in the effectiveness of preventive and curative services.

As president-elect of the Canadian Medical Association — the eighth woman in our 150 years and the first female surgeon — I’m passionate about ensuring work-life balance for all physicians because healthy physicians lead to better patient care and a more effective health-care system.

Canadian doctors are ready and willing to tackle this issue, and we are equally committed to driving change and removing barriers to care. This is about our health-care system, not physician gender.

Let’s drop the narrative on the difference between the volume of patients seen by male and female physicians and focus on the underlying reasons as to why our health-care system leaves so many patients without access to appropriate care.

Dr. Gigi Osler is president-elect of the Canadian Medical Association.

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