Teresa Kieser, the only female cardiac surgeon in Alberta, has filed a human-rights complaint against the province’s health agency, Alberta Health Services, alleging years of pay inequity, pervasive sexism and gender-based discrimination.
Dr. Kieser alleges that since beginning her career as a cardiothoracic and vascular surgeon in 1988 at Foothills Medical Centre in Calgary, where she still works, she has been made to battle institutional barriers, harassment, a general lack of respect and many baseless complaints about her professional abilities – all because she is a woman.
The most recent professional complaint resulted in Dr. Kieser losing her surgical privileges for more than a year, which is what prompted her to finally take legal action, she says.
That complaint was lodged in November, 2020, by a male colleague, who raised questions about her technical abilities and clinical judgment relating to two patient cases. This triggered an external investigation, and Dr. Kieser was unable to perform surgeries while the review took place, she says in her Alberta Human Rights Commission claim.
A few months into that investigation, the external reviewer informed Alberta Health Services – which runs health care in the province – that properly assessing the complaint would require a five-year data analysis of Dr. Kieser’s work compared with the other surgeons in her group.
AHS took no action, and so the matter was referred to a hearing, the claim says. That hearing was scheduled for January, 2022, more than a year after Dr. Kieser stopped performing surgeries. But just before it took place an agreement was reached, according to her lawyer, Sophie Purnell. It was decided the accusations would not be pursued, and Dr. Kieser’s surgical privileges were restored.
The allegations against AHS have not yet been evaluated by the Alberta Human Rights Commission. In a statement to The Globe, AHS said it could not comment on the case.
Dr. Kieser is the second prominent female heart surgeon in Canada to file such a claim.
Last year, Irene Cybulsky won a gender discrimination case against Hamilton Health Sciences after the Human Rights Tribunal of Ontario concluded that gender bias had played a role in her ouster as the head of the hospital network’s cardiac surgery team.
She had been the first woman to hold the position in the network’s history, but lost the job after some of her male subordinates – all the surgeons on the team she presided over were men – raised concerns about her leadership style, prompting an internal review. During that process, comments from the men included that she was not soft enough and that she was “like a mother telling her children what to do.”
The tribunal has not yet held a hearing to decide on remedies for Dr. Cybulsky’s complaint.
Because there is a one-year limitation period on human-rights complaints, Alberta’s commission will only evaluate the most recent incidents included in Dr. Kieser’s complaint – primarily the events that led to her losing her surgical privileges. But the 11-page document details years of alleged mistreatment and misogyny as context for later events.
The claim describes four times when male colleagues raised concerns about Dr. Kieser’s surgical abilities and judgment. According to her claim, the first complaint about her technical skills was made in 2004, and an outside reviewer found no merit to the allegation. Then, in 2013, according to the claim, one of Dr. Kieser’s male superiors told her she was taking longer than her male colleagues to perform certain procedures. He allegedly suggested she retire. (Dr. Kieser is now 70 years old. Her human-rights complaint also alleges age discrimination.)
“Dr. Kieser explained that she uses a different operation technique than her colleagues, which takes more time,” the claim says. (The technique involves using arterial grafts rather than vein grafts, the former of which last longer. The claim says this technique is now becoming standard practice.) An external reviewer again found the concerns about Dr. Kieser’s skill to be baseless, according to the claim.
The claim describes a third incident, in 2019, when the wife of a patient of one of Dr. Kieser’s male colleagues approached her for help. The woman was worried about the care her husband was receiving from a male physician, and she asked Dr. Kieser to speak with the doctor, which Dr. Kieser did.
The man “became very hostile,” the complaint says, and he told Dr. Kieser that questioning his care was unprofessional, and that she should “be very careful.” A month later, that male doctor filed a complaint against Dr. Kieser, challenging her performance and technical abilities. The complaint was not pursued, the claim says.
From the very beginning of her time as a surgeon, Dr. Kieser says in her claim, it was clear some of her male colleagues automatically thought less of her because she was a woman.
For example, when she led the cardiac surgery program at Foothills Medical Centre – in fact, she was the first heart surgeon there – all of her counterparts from other specialties were referred to as “chief,” but she was addressed by a subordinate title: “co-ordinator.” All of the cardiac surgeons appointed after her were immediately referred to as “chief,” she alleges in the claim.
In a reply sent to the commission, AHS denies that Dr. Kieser was ever discriminated against. The health agency is also challenging the admissibility of any alleged incidents outside of the one-year limitation period.
In one section of the reply, the agency argues that Dr. Kieser is not an employee of Alberta Health Services. Rather, it says, she is a physician with privileges that allow her to provide clinical services at AHS sites. (This is the employment situation for most doctors in the country. Physicians are essentially independent contractors that invoice the government directly for services.)
Last year, The Globe and Mail looked at the unique challenges facing women in medicine as part of an investigative series called Power Gap, which examined gender inequities in the work force. Female doctors reported being pushed into less lucrative specialties than men during medical school, receiving fewer referrals, getting less mentorship, taking harsher criticism and having their skills doubted by both male colleagues and patients.
A Globe analysis of medical leadership at Ontario’s 10 largest hospital corporations found that just 32 per cent of department chiefs, 29 per cent of division heads and 23 per cent of those with prestigious research positions were women, despite the fact that the number of male and female first-year medical residents has been more or less equal for two decades. About 30 per cent of department chiefs appeared to be racialized, and the numbers were similar for men and women.
In an interview, Dr. Kieser said that over the years she had always felt what was happening to her was wrong, but that it had never occurred to her to formally file a complaint. Women pay a huge price if they complain, she said.
“I thought if I just put my head down and do my work really well, it would save the day. I felt if I advanced – if I wrote papers, was discovered – maybe I could escape this. But the higher I rose, the worse it got.”
When she lost her surgical privileges – and the ability to do what she loved – that, she said, was the breaking point. And not just because of the pain it caused her personally, she added, but because she worried about what doing nothing would mean for the next generation.
“Four out of the eight cardiac surgical residents at Foothills are women. I realized, if I don’t take a stand here and say something, this could happen to them. It will never stop unless someone points out what’s happening.”
In her claim, Dr. Kieser asks for $500,000 as compensation for pain and suffering, plus repayment of lost wages (her lawyer estimates that amount is around $480,000). She also asks that AHS be ordered to run education programs designed to eliminate sex, gender and age discrimination within the cardiac surgery department.
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