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The emergency entrance to St. Michael's Hospital, in downtown Toronto, on Oct. 21, 2020.Fred Lum/The Globe and Mail

Male doctors disproportionately refer patients to male surgeons over similarly qualified and experienced female surgeons, a study from a Toronto hospital suggests.

The study from Unity Health Toronto and ICES, published Wednesday in the medical journal JAMA Surgery, analyzed and compared nearly 40 million referrals to 5,660 surgeons in Ontario over a 10-year span from 1997 to 2016.

It found that male surgeons, who accounted for 77.5 per cent of all surgeons, received 87 per cent of referrals sent by male doctors, compared to 79 per cent of referrals from female doctors.

Researchers found the differences in referral volumes and types could not be explained by patients’ choices nor by characteristics of the surgeon, such as age or experience.

Dr. Nancy Baxter, senior author of the study and a scientist with the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, said she had had a sense over her 20 years in practice that male surgical colleagues were getting more referrals.

“Our work demonstrates that my observations were not unique, but reflect gender bias that affects the lives and livelihoods of all female surgeons in the province,” Dr. Baxter said in a release.

The data indicated male doctors were 32 per cent more likely to refer patients to a male surgeon while female doctors were 1.6 per cent more likely to refer patients to a female surgeon.

The study also found that the discrepancy did not improve over the decade, even as more women became surgeons.

The research builds off previous work from the lead authors that suggested female surgeons in Ontario earned 24 per cent less per hour while operating compared to male surgeons.

They say the findings of this study suggest male physicians hold biases that disadvantage female surgeons, further widening the gender pay gap in medicine.

Dr. Fahima Dossa, co-lead author and general surgery resident at St. Michael’s Hospital, suggested changes to the referral process, including a single-entry referral mode that would schedule patients with surgeons based on who is available first.

“There is an often-made assumption that sex-based inequities in medicine will naturally improve as more women enter medicine and acquire experience,” Dr. Dossa said in a release. “In contrast, our study demonstrates that inequities will not improve without active intervention.

“The time is now ripe to enact change.”

This content appears as provided to The Globe by the originating wire service. It has not been edited by Globe staff.

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