Physician Pay Inequity: Time to Act?


Physician Pay Inequity: Time to Act?

Lauren Eastman; Sukhy K Mahl; Shoo K Lee

Canada’s primary health care system is in crisis, with increasing numbers of Canadians having difficulty accessing a family physician (FP). FPs form the backbone of our healthcare system and act as patient care coordinators and gatekeepers. In 2021, 4.7 million Canadians, or 14.5% of the population, aged 12 and over, did not have a primary care provider. Even more troubling are projections that the situation will worsen in the future. Between 2020 and 2022, the number of primary care network doctors in Alberta accepting new patients dropped by half. In 2022, the overall supply of FPs grew by only 1.2% versus 2.8% for specialists. A key issue underlying this problem is physician pay inequity. FPs are among the lowest paid physicians. In 2019, full-time specialists in Canada received 40% higher payments than FPs and the income gap continues to widen. This has led to fewer medical school graduates choosing family medicine as a career, reduced access to community-based FPs, and increased burden on hospital emergency rooms. Since the 1990s, provincial governments and medical associations have attempted to rectify this pay inequity, yet the problem continues to worsen. In this article, we discuss the significance of physician pay inequity, review provincial efforts to reduce these inequities, and provide policy options to resolve the problem.

Eastman, Lauren et al (2023). Physician Pay Inequity: Time to Act? Canadian Health Policy, DEC 2023.;

Lauren Eastman, BMSc, MD, CCFP, Family Physician; Assistant Professor and Assistant Program Director (Urban family medicine residency program), Department of Family Medicine, University of Alberta, Email:

Sukhy K. Mahl, MBA; Assistant Director, MiCare Research Centre, Mount Sinai Hospital; Email:

Shoo K. Lee, MBBS, FRCPC, PhD, DHC, OC; Professor Emeritus, University of Toronto; Honorary Staff Physician, Mount Sinai Hospital; Email:

Funding statement      
Although no specific funding has been received for this study, organizational support was provided by the Maternal-Infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a Canadian Institutes of Health Research (CIHR) Team Grant (CTP 87518) and the Ontario Ministry of Health. Dr. Eastman also receives an honorarium to sit on the College of Family Physicians of Canada Family Medicine Examination Committee. The funding agencies had no role in the design and conduct of the study; collection, management, analysis and interpretation of the data; preparation, review or approval of the manuscript; and decision to submit the manuscript for publication.

Publishing status
Peer reviewed. Submitted: 24 OCT 2023. Published: 15 DEC 2023.