Thank you, chair and members, for this opportunity to speak.
I'm Dr. Fiona Mattatall, and I've worked for two decades as an obstetrician-gynecologist in Calgary, Alberta. As such, I am a specialist in both the medical and the surgical care of the organ system that includes the vulva, vagina, uterus and ovaries. I am one of your frontline workers in women's health, but this also extends to the care of gender-diverse Canadians. I am a clinician, but also an educator and an assistant professor at the University of Calgary.
It is refreshing to see the standing committee address women's health and specifically not focus solely on pregnancy. All too often, women's health is reduced to maternal health only. An example from here in Alberta is that our strategic clinical networks focus on maternal health, and there is no place for advocacy for non-pregnant women's health issues, such as contraception, heavy periods, pelvic pain, menopause or pelvic organ prolapse.
Although it was reassuring in Monday's meeting to learn about the recent work and funding through the sexual and reproductive health fund, we see a lack of prioritization of sexual and reproductive health across the country. Again, here in Alberta, the surgical metrics that we see tracked are cataracts, knee replacements and hip replacements. We see no tracking on things such as wait times for hysterectomies or any other gynecological procedures.
Every day in my clinic, I witness Canadians who cannot fully participate in life or work due to gynecologic issues. Patients are affected by the lack of health prevention, the lack of health awareness and delayed diagnosis. Many times, I feel that my hands are tied, as patients cannot afford medical options or they sit on my surgical wait-list for over a year.
I am sure you will hear specifics from experts tonight with regard to endometriosis, but this also extends to heavy periods, menopause and, again, pelvic organ prolapse. This is further exacerbated by the difficulty accessing evidence-based holistic care for these conditions, such as pelvic floor physiotherapy.
I am sure that your committee is aware of the historic and current issues of gender inequality in medicine. Pelvic pain has long been dismissed, and I am one of those physicians who has been on both sides of the diagnosis.
Endometriosis, as a disease, has for too long been neglected as a priority in research and in treatment. While this has improved slightly in recent years, there remains a significant and unaddressed gap when it comes to other areas of medicine. As you will hear today, endometriosis is a complex disease for which treatments are focused on medication and surgery, but there is also a longer-term chronic pain aspect that requires multidisciplinary teams, and many aspects of these are poorly supported in Canada.
Specific to gender inequity and surgery in our own country, you might be interested to find out that reimbursement for surgeries on Canadian women pays 26% less than that for the equivalent surgeries on Canadian men. The study that cites this data is attached to my notes. That gynecology is the only majority female surgical specialty is a double hit of gender inequity to both the patient and the physician.
I have three suggestions for the standing committee this evening. Number one is to include key performance indicators for women's health in all system evaluations. Number two is to require provincial health organizations to apply a gender lens to health care resource allocation. Number three is to support the passage of a national drug plan, and specifically include contraception and medications that treat pelvic pain and heavy periods.
Thank you.