If You Want to Pay Less, Cherchez la Femme-A National Survey of Private Psychiatric Fees in Israel and Gender Gap

Background: Private expenditure for mental health services in Israel is higher than for general health services. Sadly, individuals with severe mental illness often have fewer financial resources, and thus face a barrier when seeking psychiatric care. The aim of this study was to ascertain the costs of private ambulatory psychiatric services in Israel, and to characterize demographic differences that may impact cost of care. Methods: An anonymous questionnaire regarding socio-demographic information and self-reported fees for private psychiatric services was distributed among registered Israeli psychiatrists. Results: Of over 1,100 psychiatrists contacted by email, 175 psychiatrists responded, and of those 71 (40.6%) completed the section on fees. Among psychiatrists were considerable discrepancies regarding fees for the same psychiatric services and procedures. Female psychiatrists charged an average of 36.7% less than their male counterparts (1,229.42 vs. 1,680.86, p value = 0.4), despite similar services rendered. Conclusions: This study is the first to show gender pay gap among psychiatrists and is in accordance with similar gender pay gaps found in other medical specialties. Cultural and social reasons for lower billing by female psychiatrists should be further explored.