Ontario study reveals female family doctors spend more time with patients, earn $45K less annually

A study released this week in the Canadian Family Physician journal has quantified something many have suspected: female family doctors in Ontario are doing more work for less pay. The research, drawn from surveys of over 1,050 physicians between August and October 2023, found that women in the profession spend 15 to 20 percent more time with each patient than their male counterparts. That translates to roughly four additional minutes per visit—time that, under Ontario's current payment structure, goes largely uncompensated.

The financial toll is substantial. The income gap between male and female family physicians averages $45,500 annually. To earn what their male colleagues make, female doctors would need to work approximately two extra hours every single day, according to the study's authors from the Ontario Medical Association and McMaster University. The culprit, researchers argue, is the fee-for-service model that dominates compensation in the province—a system that rewards volume of services rather than quality of care or time invested in individual patients.

Dr. Zainab Abdurrahman, president of the Ontario Medical Association, framed the problem plainly: the current system incentivizes speed over substance. "We shouldn't be penalizing doctors for doing what patients in the system really need," she said. The irony is sharp. Female physicians, on average, are providing exactly what evidence suggests patients benefit from most. A 2016 study found that patients treated by female physicians experienced fewer emergency room visits and hospitalizations—measurable improvements in health outcomes that the fee-for-service model does not reward.

Dr. Kim Lazar, a family physician at North York General Hospital, embodies this tension. She routinely schedules half-hour appointments instead of the standard 15 minutes, a choice driven by the reality of her patient population. Many of her patients contend with eating disorders, depression, and other complex conditions that cannot be adequately addressed in a quarter hour. "Obviously patients who have complex health needs and mental-health concerns, which leads to longer visits and more frequent visits, would prefer that type of care," Lazar said. Yet under the current compensation structure, her commitment to thorough, empathetic care comes at a direct financial cost.

Research cited in the study suggests that the time difference reflects not inefficiency but different communication styles. Female physicians, studies have shown, tend to engage in longer discussions and adopt a more collaborative, empathy-centered approach to patient relationships. In an era of rising misinformation and patient confusion about health, Abdurrahman noted, these relational skills are not luxuries—they are necessities. "In this climate where misinformation is increasing at an alarming rate, you need to be able to have those kinds of relationships," she said.

Relief may be coming. Beginning in April, Ontario will introduce a new blended compensation model that gives family physicians the option to bill for time spent on direct patient care, indirect patient care, and clinical administration. The shift represents a structural acknowledgment that not all valuable medical work fits neatly into a fee-for-service box. Abdurrahman described these hybrid models as a pathway toward eliminating the built-in disadvantages that currently penalize doctors—disproportionately women—who practice medicine in a patient-centered way. Whether the new model will close the gap remains to be seen, but the study has made clear that the current system is not neutral. It is actively discouraging the very behaviors that evidence shows improve patient outcomes.