Doctors paid 5 times more than nurses and pharmacists to give COVID-19 vaccines

Doctors were paid significantly higher rates than nurses and pharmacists for administering COVID-19 vaccines, Ontario's auditor general has found.

“The Ministry of Health and the Ministry of the Solicitor General did not oversee equitable and reasonable payment processes for vaccinators,” the report, which was released Wednesday, said.

According to the auditor general, doctors received about $170 an hour to work in a mass vaccination or mobile pop-up clinic operated by a public health unit or hospital, while nurses received between $32 and $49 an hour.

Registered practical nurses were paid even less.

Pharmacists were paid about $30 an hour to work in a public health mass vaccination or mobile clinic and between $43 and $57 an hour at a hospital.

“While the Ministry of Health informed us that it paid physicians more than nurses because doctors generally are paid more, it did not have an analysis to show this was fair given that health-care professionals all performed this task at vaccination sites,” the report said.

The ministry also allowed physicians to bill $220 an hour if they worked outside of their usual Monday to Friday business hours.

Despite evidence suggesting that encouraging vaccinations at primary care officers would help address vaccine hesitancy, the report found that physicians were not incentivized to provide vaccinations in their offices.

While physicians were paid between $170 to 220 an hour by the ministry to work at vaccination sites, the auditor general found that doctors who worked out of their offices received $13 per dose.

This rate was “also meant to cover overhead and administrative costs of vaccinating, such as personnel for data entry.”

“More than 6,000 physicians billed the province at the hourly rate for COVID-19-related work, while just over 3,000 billed the province for office vaccinations during this period,” the report said.

Hourly compensation provided to health-care workers to administer the COVID-19 vaccine. (Auditor General Report)

The report found the average physician billed $30,488 to work at a vaccination site or assessment centre operated by a hospital. That amount dropped to $2,565 for physicians working in their own offices.

Auditor General Bonnie Lysyk said it was a “surprise” to see the different rates but stopped short of saying whether it was acceptable or not.

“When we asked why there were differences in the rates, the answer was it was associating the person with their profession versus the execution of the work,” Lysyk told reporters Wednesday.

“Could money have been spent better at a lower cost, potentially. I think we just highlighted that for fact -based information and it's for others to look at and think about that going forward.”

A survey of 34 public health units found about 40 per cent thought physicians were overpaid for their work at mass immunization clinics and that their workloads were not in line with the compensation, the report found.

It also found nine public health units flagged that lack of involvement from doctors and primary-care offices was a major issue in the vaccine rollout.

This isn’t the first time nurses have experienced pay differentials that have left them feeling underappreciated and undercompensated.

In May 2021, CTV News Toronto learned that physicians redeployed in hospitals to help with critical care due to COVID-19 outbreaks were being paid significantly more than nurses doing similar work.

• Nurses call for better pay amid amid COVID-19 pay discrepency

Doctors who were redeployed during the pandemic received what’s called “temporary physician funding” from the government, as part of an agreement between the province and the Ontario Medical Association (OMA).

According to a pay scale from an April 2020 memo, a physician deployed to the ICU between 7 a.m. and midnight received $385 an hour, or $450 an hour for the midnight to 7 a.m. shift.

Someone in Ward Care could get $250 an hour from 7 a.m. to midnight while administrative non-clinical assignments are given the price tag of $165 an hour.

A registered nurse working in an Ontario hospital who has 25 years of experience, on the other hand, received a rate of $48.53 an hour regardless of where they worked, as of April 2021. A nurse with five years of experience made $40.19 an hour.

The $48.53 rate is only 48 cents more than what a nurse with 25 years of experience was receiving in April 2020.

At the time, the OMA and the Ministry of Health said the temporary physician funding is based on the standard fee-for-service agreement used by doctors, and did not include any COVID-19 specific incentives.

While nurses did receive a temporary pandemic pay, which offered some health-care workers $4 more an hour for 16 weeks, general wages for nurses have been capped at one per cent by Bill 124.

On Tuesday, a court struck down the legislation, which limited wage increases for most public sector workers. An 80-page decision found the bill infringes on the applicants’ rights to freedom of association and collective bargaining.

The Ontario government has said it intends to appeal the decision.