A new study shows female family physicians spend more time with their patients than their male colleagues, confirming what physicians have long reported anecdotally.
The research, published on Jan. 14 in the journal Canadian Family Physician, was conducted by Healthcare Evaluative Research (HER) at the Ontario Medical Association and McMaster University. The findings support ongoing efforts to understand and address gender pay inequities in medicine.
Researchers found female family physicians spend 15 to 20 per cent more time per patient encounter than their male colleagues across a broad range of services. For the most commonly billed family medicine visits, women spent nearly four minutes longer per appointment. This pattern held true across 19 of the 20 services analyzed, with the only exception being the Papanicolaou test, where time spent was the same.
“In a fee for service system like Ontario’s, where delivering the maximum number of services possible is the priority, physicians who spend more time with their patients are at a disadvantage,” says Dr. Lyn Sibley, Senior Director of HER at the OMA.
A 2021 JAMA study that analyzed data from more than 30,000 physicians found a 13.5 per cent pay gap between male and female physicians. Combined with the new findings, this suggests women in family medicine are delivering more care but are not being paid for it.
“Current payment models do not account for time spent, thereby potentially structurally disadvantaging female physicians in terms of overall earnings,” said Dr. Boris Kralj, an adjunct assistant professor at the McMaster University Department of Economics and the Centre for Health Economics and Policy Analysis (CHEPA).
“The gender pay gap in family practice could be reduced if current fee structures were replaced by, or amended to include time-based payments.”
Spending more time with patients matters. Family doctors who listen closely and communicate effectively are more likely to uncover critical details, make accurate diagnoses and build trust. Patients who feel heard report stronger relationships with their physicians and have better health outcomes, yet the compensation system generally rewards speed.
Physicians who take longer with appointments typically see fewer patients in a day, which results in lower overall earnings. To earn the same income as their male counterparts, a female family physician would need to work roughly two additional hours per day.
Over the course of a year, this difference amounts to an estimated income gap of about $45,500 for a physician working a standard schedule.
The study also found the gender gap in service times was less pronounced among international medical graduates and physicians who completed residency training outside Canada, suggesting that training and cultural norms influence practice styles.
To truly close the gender pay gap, researchers are urging the adoption of a compensation model that values patient outcomes, not patient volume. Fair pay should reflect both the quality and quantity of care delivered, especially when better care leads to healthier patients.