Fee-for-service statistics suggest physicians under 40 bill less

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TORONTO – A large proportion of doctors under 40 are billing the health-care system for less than what a “full-time equivalent” doctor would bill, an analysis of fee-for-service payments to doctors suggests.

Three-quarters of female doctors under 40 fall into this category, and half of male doctors under 40, the report released Thursday by the Canadian Institute for Health Information shows.

“Full-time equivalent” is a measure used to estimate whether a physician is working full time versus part time, not based on the hours they work but on the payments they receive for their services.

“Although we don’t entirely have the full reason for that, we speculate that physicians under the age of 40 – I guess like many of other people in the economy – obviously have greater family responsibilities and so on,” explained Geoff Ballinger, manager of health human resources at the institute.

“And they tend to have a slightly different work-life balance than older physicians. And women physicians also seem to have a different approach to working their practice as well.”

The report, entitled “Physicians in Canada: Average Gross Fee-for-Service Payments 2005-2006,” said the total payout in Canada for fee-for-service billings was $10.9 billion in 2005, up from $10.1 billion the previous year.

“We are seeing recently larger increases in physician payments … this particular number is just the fee-for-service component,” said Ballinger.

Fee-for-service payments account for about 80 per cent of what doctors receive collectively in Canada; other income might come from salaries, contracts and other fees.

The report said the average gross for a full-time family physician was about $211,600 per year, out of which taxes and overhead had to be paid.

For a specialist, the average was $281,000.

The highest average payments per doctor were in Alberta, Saskatchewan and New Brunswick, while the lowest were in P.E.I. and Quebec.

The findings on whether doctors are working the equivalent to full time are of interest to health planners because of concerns about physician shortages.

“Women now make up almost 50 per cent of the physicians under the age of 40, and if they practise differently than physicians did in the past, then this could have an implication in terms of whether we’re going to have enough physicians in the future,” Ballinger said from Ottawa.

The data reflect the findings of a 16-page survey distributed in 2004 by the College of Family Physicians, the Canadian Medical Association and the College of Physicians and Surgeons of Canada.

The organizations polled nearly 60,000 doctors across the country, and had responses from 36 per cent. They found female doctors work on average seven fewer hours a week than their male counterparts. Doctors of all ages and both genders said they need to work fewer hours.
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