Thank you Madam Chair, and good afternoon.
As you said in introducing me, I am Anne Doig. Like the chair, I am a family physician. I provide complete family medicine services, which means that I treat patients in hospital and in my office, including obstetrical services. I have practised in Saskatoon for nearly 32 years.
It is my pleasure to be here today. As president of the Canadian Medical Association, I represent all physicians, but today I am proud to represent women participating in what is now a traditional occupation for them, and that is medicine. Joining me today is Dr. Mamta Gautam, a specialist and champion of physician health and well-being. For 20 years she has worked as a psychiatrist treating physicians exclusively in her private practice in Ottawa, and has been hailed as the doctor's doctor.
The Association of Universities and Colleges of Canada has reported full-time university enrolment increased by more than 190,000, or 31%, between 2000 and 2006. It now stands at record levels. Full-time male enrolment has surpassed 350,000 students and full-time female enrolment has surpassed 460,000. Women account for two-thirds of full-time enrolment growth since 1971, a surge driven by the rapid increase in women's participation in the professions, including medicine.
As it stands now, men outnumber women among practising physicians, 67% to 33%. While there are still more men than women in practice, the percentage of female first-year residents in 2008 was 57%. This is a reversal of the percentage when I graduated, and an increase from 44% just 15 years ago. This means that a significant majority of physicians close to the beginning of their medical careers are women. Not surprisingly, given those figures, there are many medical disciplines where the proportion of women is much higher than it was even just a few years ago. For instance, in general surgery--long held to be a bastion of male physicians--women comprised 18% of the 1993 first-year residents. That's compared to 40% in 2008. And in 1993 just over half of first-year family medicine residents were women, compared to 64% today.
However, women medical graduates still tend to choose residency training in family medicine, pediatrics, and obstetrics and gynecology in greater proportions than their male counterparts. As has always been the case, males continue to have a stronger preference for surgery, at 23%, compared to 11% of females--although that gap is narrowing. The overall numbers of women physicians are increasing, as are the percentages of those going into what one might call non-traditional specialties, albeit at a slower rate.
The so-called feminization of medicine brings with it several other issues, and I will touch on two major ones. The first is the work and home balance. The rise in the number of women physicians is bringing a positive shift in the way physicians practise and the hours they keep. Very few of today's young physicians, male or female, are willing to work the long hours that physicians of previous generations did. That said, data from the 2007 national physician survey, which included responses from over 18,000 physicians across the country, show that on average male doctors still work nearly 54 hours per week. Female doctors work 48 hours--although many work more than that.
These figures do not include on-call time, nor time spent on child care or other family responsibilities. Many members of the committee can empathize with this level of commitment. In contrast, the European Union's work time directive has said that the maximum work week must be 48 hours. If Canada were to try to apply that directive to physicians, our health care system would grind to a halt.
The number of physicians opting to be paid by a means other than fee-for-service has dramatically increased. Fee-for-service rewards the doctor financially for seeing more patients. Female physicians typically spend more time in each patient encounter, a trait that is valued by patients but not rewarded by fee-for-service remuneration.
The second issue is stress. In spite of their increasing numbers, women in medicine still report higher rates of incidents of intimidation, sexual harassment, and abuse than their male counterparts. As well, many female physicians continue to assume primary responsibility for home and family commitments in addition to their practice workload, thus compounding their stress levels. Female physicians are more likely to work flexible hours. Flexibility in work schedules has been the method by which female physicians balance their professional and personal lives. Yet as they take on more and strive to be more flexible, that in itself creates more stress as they battle to be all things to all people.
In its 1998 policy on physician health and well-being, the CMA recognized the need to address and alleviate the special demands placed on women physicians. I have brought copies of that document with me today for you.
As I said at the outset, Dr. Gautam, who is with me today, is familiar with the stress factors experienced by physicians and women physicians in particular. She has broad experience in treating them.
We will be happy to discuss the participation of women in medicine and to answer questions that you may have.
Madam Chair, if I may, I do wish to apologize to the committee for the fact that I will have to excuse myself at five o'clock for an event by Senator Keon. With your indulgence, thank you.