Helping women physicians thrive financially

In addition to earning less due to a gender pay gap, female doctors come up against other financial inequities on the job such as being tasked with uncompensated work or lacking return-to-work support post maternity leave. In this podcast, Dr. Stephanie Zhou, a Toronto addictions physician and financial lecturer, breaks down how to overcome these barriers, while offering valuable fiscal advice to help women flourish financially.

Transcript

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Georgia Balogiannis: In this podcast the Ontario Medical Association looks at current issues of interest in health care. Spotlight on Health gives you all the straight talk. We're Ontario's doctors and your health matters to us. I'm Georgia Balogiannis for the Ontario Medical Association. 

As well as having to navigate a gender gap in their profession, female physicians face challenges financially. In this episode, Dr. Stephanie Zhou, a Toronto addictions physician and financial lecturer, explains the economic pitfalls that women doctors may face and what they can do to protect their fiscal security.

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Dr. Stephanie Zhou: Time and time again, we see in literature that there are differences between how much women and men are making. Even though we have a fee-for-service system, particularly for minority women, they do face additional responsibilities at work that are often either not paid or underpaid. And that often takes away from higher-earning clinical work, for instance.

When it comes to returning back to work after maternity leave, there has not been a lot of supports out there. Women are also rating themselves less confident when it comes to managing their finances. There is also something known as a pink tax, which is when a particular item that a man or a woman uses is basically the same item, but because it's marketed in a feminine manner, it's marketed as more expensive. So, women face lower income, and also higher expenses.

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Dr. Zhou: When it comes to how much doctors make — when I ask medical students and residents, “how much do you think an average family doctor makes per hour?” the highest-voted answer is usually about $150 an hour. But usually I tell them, you know, when you break it down, you look at the gross income — assuming you're working every week of the year — and you divide it up by day, it comes out to be about $1,000 a day, which is the typical locum rate. You take away the income tax from that, and the after-tax hourly value of your time is now $76. Not to mention there's also things like unpaid work — like charting, billing, admin stuff — and when you take those into account, you know, that further reduces how much you're making per hour. And that also doesn't include overhead deductions, as well, in this calculation. 

And so, when students see, like, $150 per hour, and they assume that's how much they make when they see $240 grand a year, um, that looks like a lot of money. But when you really break it down to how much per hour worked, it doesn't look as much, right? So, a lot of people will say, "Oh, I can't wait until I'm a staff physician." But you know, once you're a staff physician, it's still important to think about unpaid work that you're doing and how we can cut down.

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Dr. Zhou: Let's talk a bit about the top three mistakes that I find young female physicians making. So, the first one is about lifestyle and spending. There are two ways to think about spending, because a lot of people say, "Oh, well, if you're talking about controlling your lifestyle, does that mean we can't even enjoy our life at all, we have to be really stingy?" No, that's not necessarily the case. 

So, the two ways I like to think about it is, the first way basically looks at the cost of what you want to buy divided by the hours of work you're willing to put into it. The other way I personally like to look at it is cost divided by how many hours you plan to use this item for, multiply by how many days, how many years, and so on.

I like to look at things in terms of the hourly cost of use because when I was a medical student, I didn't really have, like, an income or, like, an hourly wage or anything like that, or hourly billing amount. So, I started looking at it in terms of how much it would cost me to use this item per hour.

But here's an example. I have a pretty expensive gaming laptop that costs $2,300 for me. And so, even though it is expensive, when you think about me using my laptop seven days a week, 365 days a year for eight years — because I've had it for eight years — comes out to be about 11 cents an hour. Which, you know, when you think about the overall cost is quite high, but on a per hourly basis, that's not that. And it lasted quite a long time.

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Dr. Zhou: It's very easy to have huge amounts of credits, especially in residency, especially as a student. And sometimes people often have really good credit card deals with high amounts of maximum spends. But it's important to realize that the interest rates can be quite high on a credit card and they compound daily, so this would be the fastest way to get deeper into debt, is once you start using credit cards to get into debt.

But on the other hand, credit cards can actually be beneficial, as well. If you are paying off your credit card every month, paying it off on time, and prioritizing paying off credit card debt compared to other forms of debt — or, if you can, pay off every sort of debt, but credit card debt is the first you always want to make sure you pay off.

The reason why I say credit cards can be advantageous if you have that self-discipline and control is because they do have cashback and travel points credit cards. And those can be really helpful, especially for the residents or for the med students who have big expenses coming up, like if you're paying for your licensing exams with your credit card.

Some credit card cash will give you 10% cashback in the first three months. Other credit cards might give you a really large amount of travel points. And so, I always tell people to look up these type of rating websites that tell you the best type of credit cards in Canada.

From a tax perspective, travel points credit cards can be tax advantageous, because when you make all that in terms of travel points you don't pay tax on it if it's your personal credit card because it's just too hard for the CRA to value. Like, how do you value one Air Miles point versus one Aeroplan point?

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Dr. Zhou: The second big mistake that affect a lot of females in particular is not asking to be paid for work, particularly for office housework. So, what is office housework? What does this term mean? It's basically all of the unrewarded admin items that don't actually count towards promotion or pay, and often they're given to women. And it's been shown time and time again in multiple studies that they're given to women because women are perceived as being more collegial. So, it might be involving ordering food for the whole team, printing out patient lists for staff physicians, organizing meetings, doing all the note-taking. Those are all things that take up a lot of time, particularly for women, but you know, you can’t put them on your CV.

So usually how I manage when it comes to making sure I have equal pay for equal work is often, when I'm being asked to join a committee or partake in some sort of meeting or present at some conference, I usually ask, “Is there funding available for this role, or is it a volunteer role?” There's no harm in asking, because oftentimes people don't ask, and so they just automatically don't get paid for it. But I've started noticing that just simply by asking, it sets the precedent for everyone after you in that particular role you have that there is an expectation to be paid for that role or to have funding for that role.

Particularly for women of colour, I think it's important to set that precedent. Especially if you're doing diversity-related work to encourage that there be funding for that work.

And finally, if you're doing a certain task that you just absolutely don't have time for, how do you say no? It can be hard to tell someone no directly, especially if they're your chief of department or something. But often, there are actually a lot of individuals out there who want to be on committees or who want to take more leadership positions, but perhaps you may not necessarily have the time for it, but you want to help others in their career as well. So, if you actually do think it's a very good opportunity, I do definitely encourage you to look at your colleagues and share those experiences that you get along as well.

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Dr. Zhou: Finally, the third mistake is losing money through relationships. Time and time again, especially for immigrant women like myself, we're often the sole providers when it comes to our parents and helping our parents with their retirement savings. And often, there's an expectation that, as a female, we're the caregivers of our parents.

In order to try to maintain the relationship it might have a financial impact on us, because when I lend money to my parents I may not expect to get it back, nor do I want to ask them for it back. I genuinely wanted to help them. However, sometimes you realize if you're not signing a contract with a family member, the chances of you getting it back, it's unlikely — so it's important to even consider budgeting for it.

I also want to briefly touch upon financial abuse because financial abuse does happen to women who are university educated, women who are high earners as well. And especially when women who do have higher earning power, sometimes you might hear partners, especially if there is an abuse situation, they might say, "Oh, just let me handle the finances, I know more about it than you." Or, "You're such a busy doctor, why don't you just give me all your passwords for all the accounts, I'll pay all the bills." Or they might say, you know, "You need to pay for this because you make more than me," while doing all the housework as well. So, it's all about fairness.

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Dr. Zhou: Investing refers to buying and holding for a long term. When you're investing in something, you're trying to ensure that you're getting a profit in the end. When you look at the overall stock market over many years, like decades, you notice that there are big swings, even right now we're going in a downturn. But over decades, it goes up. And that's the reason behind the term “buying and holding”.

Trading is referring to buying based on frequency and analyzing trends in the market. Every time you make a trade it has a fee that you might be paying. Those fees are what is making you lose money compared to buying and holding where you just pay a one-time fee, for instance.

I personally don't do these short-term trades. I personally do buy and hold because when you look at strong industries and a wider market over time, it goes up, and you're not chasing these returns.

So, when it comes to investing, I always put these five rules. It's important for you to understand and research your investments. Don't buy something because everyone's buying it. And this is in behavioral finance, is known as herd instinct. It results in you panic buying and selling. So right now, even though you might notice a lot of your stocks going down, I wouldn't panic sell at this time because you'll notice that everyone's selling at this time, everything's going down, you're losing money when you sell.

Diversifying across different investment types, countries and sectors — a lot of us have familiarity bias, we tend to invest in what we know and what we hear most about, but sometimes this might skew your investments. You can't control where the market is going but you can control your costs. For all of your investments, you might notice there's something called an MER, management expense ratio. Or sometimes when you buy an investment, you might notice there's a particular fee you have to pay with buying or selling that investment. And those costs can add up over time. So that's why it's just better to put in a one-time investment and keep it for a long time.

And then finally, average, boring, and long term —it's not a bad thing. When women are empowered financially, when they do have a strong financial background and confidence, they actually end up being better investors than men, because they tend to have more patience. They're more calm in down markets like what's happening today, and they're also more interested in alternative views, like they're willing to seek advice, and women tend to be higher users of financial advisors than men. They do take ownership of mistakes, they tend to buy and hold instead of trade, and they tend to do more research before they invest.

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Balogiannis: This podcast is brought to you by the Ontario Medical Association and is edited and produced by Jodi Crawford Productions. To learn more about the Ontario Medical Association, please visit oma.org.

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