The List — Why Can't I Find a Family Doctor?

A brief word before we deal with the vagaries of what it is like trying to get paid as a doctor for the work we do (no, it isn’t a given that we will get paid); let’s first deal with The List.

The List goes by different names. In my province it is called, by most, The Sunshine List. It is the list, published yearly by provincial governments, of all the money the greedy doctors make. Ok, the “greedy” part is implied more than stated outright, but you know it is there. Provincial governments discuss it in terms of social accountability, letting the public know how well they are maintaining the public purse … by publishing how much doctors make … by name … to the penny.

It is contempt wrapped in voyeurism. It is like driving by a car accident; we don’t like to admit it, but most of us want to have a gawk and see what is happening. Being able to look up what “your” doctor is making (providing you have one). To see how much the highest earning doctor makes. The top ten. Goodness, just look at all those numbers!

But you protest, they do the same thing for all public servants. Perhaps, but doctors are, for the most part, not public servants. While some are employed by a hospital or Regional Health Authority (RHA), many (in some provinces most) are not. They are paid by the government for work they do in the same way insurance companies pay doctors for some services not cover by the government. They are, at best (and I am not sure I entirely agree with this characterization), contractors doing work paid for by the government. As such, you don’t have any more right to know how much I am making than I do about you. Essentially, all governments in Canada have an effective monopoly on physician payment, so (with certain limited exceptions) it isn’t like I can choose another payer to keep my name out of The List.

All that said, human nature is such that we do gawk at the car crash and most people do read The List, and no amount of me complaining is going to stop that. If I can’t make you ignore The List, I have another idea; I want to change the way you read The List.

Most people read The List from the top; that’s where all the good voyeurism is, isn’t it; seeing what all the top money-makers made. Maybe you have a gawk at the top ten, maybe the top twenty. Eventually, all those big numbers do what government intended them to do, leave you with the conviction that all doctors make a lot of money.

Next time The List gets published, I have a suggestion for you; start at the bottom. What doctor made the least amount of money? How much was that? Was it a Family Doctor? How many doctors earned less that $100K (and do you consider $100K to be a lot of money)? How many of them were Family Doctors?

I did that using data from the 2022 version of our List. At that time, the Ministry of Health, per to the Government website, was earning $95,357 (apparently, Ministers salaries are not calculated to the penny). According to The List, thirty-eight percent of the doctors in my province were earning less than the Minister of Health; thirty-nine percent of the doctors earned less than $100K. Of course, those are just the gross figures; luckily, the Minister doesn’t have to pay overhead like rent, heat, light, employee salaries, malpractice insurance, Medical Association fees, Licensing fees, office supplies and IT support; the kinds of expenses a small business pays. Because that’s what most doctors are, small business operators.

So, if you are going to look at The List, can you at least start at the bottom, where The Government does not want you to look, to give you a real sense of how many doctors are neither greedy nor rich.