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More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023
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More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Many general physicians (GPs) and specialists in Canada find their work rewarding but are concerned about compensation. For close to two thirds, compensation remained the same or increased in 2022 vs 2021, but one third experienced a decrease in earnings.
These findings emerged from an online survey of close to 700 Canadian physicians across specialties and provinces who provided data on their income, expenses, practice changes, and the rewards and challenges of their current work situation. For the most part, responses were similar among men (63% of respondents) and women (35%).
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Survey respondents (63% of specialists, 37% of GPs) work in various primary settings, with close to half (45%) working in hospitals, followed by 19% in GP-based group practices, 15% in clinics, 9% in GP-based single-handed practices, and the remainder in academic, research, military, government, and other practice types.
Although about one third (36%) work solely in their primary setting, one quarter also work in other settings, mainly clinics (25%) and hospitals (18%).
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Respondents also work in different capacities. About one third (29%) are freelance/locum, 26% are employees, 23% are single-handed GPs, and 22% are partners in a general practice.
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Practice locations also vary. Leading the way is Ontario (37% of respondents), followed by Quebec (16%), Alberta (14%), and British Columbia (13%).
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Respondents report working about 51 hours per week, on average. However, the number of hours spent seeing patients differs by subgroup.
For example, 47% overall said that they spend 30-40 hours per week seeing patients. However, more GPs (55%) than specialists (42%) reported working these hours, as did more of those in office practices (63%) vs hospitals (43%), and women (52%) vs men (44%).
Smaller percentages of each subgroup said that they work more than 51 hours. Furthermore, 3% of GPs, 4% of specialists, 1% of those in offices, 7% of those in hospitals, 4% of women, and 3% of men report working more than 65 hours weekly.
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Overall, respondents see a mean of 86 patients per week, although GPs see more patients than do specialists (117 vs 67). Office-based physicians see more patients than do hospital-based physicians (126 vs 63), and men see more patients than do women (91 vs 79).
The amount of time spent personally with each patient (not counting the patient's time spent with physician assistants, nurse practitioners, medical assistants, and other support staff) also differs.
Forty percent of respondents said that they spend between 13 and 16 minutes on average with each patient personally. About one fifth (21%) spend 9-12 minutes, 16% spend 17-20 minutes, and 9% spend 21-24 minutes.
At either end of the spectrum, 4% spend less than 9 minutes, and 10% spend 25 minutes or more. For the most part, the time spent personally seeing patients was similar among subgroups.
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Respondents also spend a good deal of their time (1-25 hours per week or more) on medical-related work outside of patient visits. This includes time spent on paperwork, administrative/managerial work, professional organization participation, clinical reading, and research, among other activities.
A little more than one quarter (26%) spend 10-14 hours on these tasks, and 21% spend 25 hours or more on them.
Again, responses are mostly similar among subgroups of GPs vs specialists, office vs hospital, and men vs women, although 26% of women vs 18% of men reported spending 25 hours or more, whereas 30% of men vs 21% of women spend 10-14 hours.
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Respondents reported earning a mean of about $370,000 for patient care services in 2022. However, specialists earned more than GPs ($412,000 vs $297,000), as did those in hospital- vs office-based practices ($416,000 vs $297,000) and men vs women ($411,000 vs $298,000).
About one half of respondents also reported compensation from other activities, such as serving as an expert witness and speaking engagements. The mean compensation for those activities in 2022 was $265,000.
That income needs to cover a mortgage on a primary residence for 59% of respondents, and a mortgage on a second home for 21%.
Most respondents also said that they live at (53%) or above (29%) their means.
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
More than one half of respondents (57%) feel that they are not fairly compensated for their work.
The percentage is higher among GPs (67%) than among specialists (51%), among office-based physicians (75%) than among hospital-based physicians (47%), and among women (60%) than among men (54%).
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Among those who don't feel fairly compensated, one third (35%) feel that they should be paid 11%-25% more, and 40% feel that they should be making 26%-50% more.
Responses were mostly consistent among subgroups, although more respondents younger than 45 years feel that they should be making 11%-25% more (41% vs 33%), and more respondents aged 45 years or older feel that they should be making 26%-50% more (41% vs 35%).
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Sixty-four percent of respondents did not experience any practice management changes in 2022. Among those who did, key changes included hiring of additional staff (21%), increasing staff hours (14%), and restoring or increasing raises (9%).
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
A large majority of respondents feel that patient-centered activities and achievements were the most rewarding parts of their job. Thirty-three percent said that "being very good at what I do/finding answers, diagnoses," is most rewarding, followed by "gratitude from/relationships with patients" (23%) and "knowing that I'm making the world a better place (eg, helping others)" (22%).
These responses drew similar proportions of respondents across subgroups.
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Most respondents report facing similar challenges: working long hours (21%), staffing levels/workload (20%), and dealing with difficult patients (17%).
However, more specialists (25%) than GPs (13%) and more hospital-based physicians (28%) than office-based physicians (8%) report challenges with staffing levels and workload. More women (26%) than men (13%) are concerned about difficult patients.
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Most respondents (82%) report being happy as a physician. Responses were comparable across subgroups, though more of those aged 45 years or older (84%) were happier than were those younger than 45 years (71%).
A smaller percentage of respondents (67%) said that they would choose medicine again if they had it to do all over again, with more men (72%) than women (59%) and more of those aged 45 years or older (70% vs 56%) saying that they would.
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Most respondents (68%) use teleconsultation to consult with patients or request expertise from a colleague. Among those who do use it, 73% are satisfied with their experiences.
A greater proportion of GPs vs specialists use this technology (79% vs 61%), as do office-based vs hospital-based physicians (85% vs 53%). More women use teleconsultation than do men (72% vs 66%), and no difference was seen by age.
Commenting on their experiences with teleconsultation, respondents said, "Hard to make an exact diagnosis without examining the patient," "Compensation not adequate for the time it takes," and "Prefer real-life encounters, but can be useful for patients."
More Than Half of Canadian Physicians Say They're Not Fairly Compensated for Their Work
Marilynn Larkin | August 22, 2023 | Contributor Information
Most respondents don't favor the use of connected devices such as activity or sleep trackers, smartwatches, or smart scales. Only 18% reported using these devices themselves; 12% said that they recommend use, and 13% said that they both use and recommend.
Responses differ among subgroups, however; 18% of GPs recommended use of these devices vs 8% of specialists and 20% of office-based vs 8% of hospital-based physicians. Again, use did not vary by age.
Follow Marilynn Larkin on X (formerly Twitter): @MarilynnL.
Physicians discuss their personal and professional happiness, how they strive for work-life balance, and successes and failures in looking after their own physical and mental health.Medscape Features Slideshows, Jan 2023
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