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- Page navigation anchor for RE: The Yukon Data is IncorrectRE: The Yukon Data is Incorrect
We appreciate Dr Poole’s time and expertise in commenting on our analysis. While we sought a diverse membership in our study committee, we did not have a member from the Yukon, and therefore, value his knowledge of the reimbursement system there. We take odds with his choice of words, “factual errors”, as there is a published fee code for the Yukon, that does reflect 41.8% lower reimbursement on the gynaecologic procedures compared to similar procedures performed in men. Moreover, the phrase “We did not include data for the Northwest Territories or Nunavut, as there were no fee-for-service specialists in obstetrics and gynecology or urology practicing there." Is, in fact, true. Moreover, there are specialists in the Yukon, including Obstetrician Gynaecologists and specialists performing the male procedures on our list. and even if they are paid through an alternative payment plan, those are presumably negotiated based on shadow billing that reflects significant gender discrepancies. Nevertheless, we do not want to inflate our results with data from the Yukon that does not directly reflect actual payments. After removing Yukon from the analysis of paired procedures by jurisdiction, the overall difference for all of Canada decreases from 28.1% to 26.7%, leaving Saskatchewan, British Columbia, Manitoba, New Brunswick, Ontario, Prince Edward Island, Nova Scotia, and Alberta as the 8 of 10 provinces with lower fee codes for procedures performed on females. We apprecia...
Show MoreCompeting Interests: I am submitting this on behalf of the entire group of authors of the original paper.References
- . 2023;:-.
- Page navigation anchor for The Yukon data is incorrectThe Yukon data is incorrect
Upon reading this article I noticed some factual errors related to the Yukon.
My main concern is that the following statement is misleading wrt the Yukon.
"We did not include data for the Northwest Territories or Nunavut, as there were no fee-for-service specialists in obstetrics and gynecology or urology practising there."
There are none in the Yukon either.
Which means these conclusions are in question.
The jurisdictions with the largest discrepancies were Saskatchewan (mean percentage difference in fees of 67.3% [SD 18.4%]), British Columbia (61.2% [SD 30.1%]) and the Yukon (41.8% [SD 21.6%]).
The obstetricians and gynecologists in the Yukon have been on an alternative payment plan for decades. There are no, nor have there been, urologists practicing in the Yukon. At most the outdated fee schedule referenced in this paper is used to shadow bill by the obstetricians and gynecologists.
While I support the main conclusions and importance of the topic it should strive to be factually correct to be taken seriously. Truth be told in the Yukon the true reimbursement of those who provide surgical care for women is exactly the opposite of that concluded in the article.
Please check your facts and correct both this error and the conclusions based on it.
Respectfully
Alexander Poole MD FRCSC
Whitehorse, YukonCompeting Interests: None declared.References
- Chaikof M, Cundiff GW, Mohtashami F, et al. Can J Surg 2023;66:E341-7.