‘The higher I got, the worse it got’: Alberta’s only female cardiac surgeon alleges discrimination in health agency complaint

dr. Teresa Kieser has filed a human rights complaint against Alberta Health Services, alleging years of wage inequality, widespread sexism and gender discrimination.Sarah B Groot/The Globe and Mail

Teresa Kieser, the only female cardiac surgeon in Alberta, has filed a human rights complaint against the province’s health agency, Alberta Health Services, over years of wage inequality, widespread sexism and gender discrimination.

dr. Kieser claims that since beginning her career as a cardiothoracic and vascular surgeon in 1988 at the Foothills Medical Center in Calgary, where she still works, she has been forced to overcome institutional barriers, bullying, a general lack of respect and many unfounded complaints about her professional abilities – all because she is a woman.

The most recent professional complaint led to Dr. Kieser lost her surgical privileges for more than a year, prompting her to finally take legal action, she says.

That complaint was filed in November 2020 by a male colleague, who raised questions about her technical skills and clinical judgment in two patient cases. This prompted an outside investigation and Dr. Kieser was unable to perform surgery while the review was taking place, she says in her Alberta Human Rights Commission claim.

A few months after that investigation, the third-party reviewer informed Alberta Health Services — which manages the health care system in the province — that to properly assess the complaint, a five-year data analysis of Dr. Kieser would be needed compared to the other surgeons in her group.

AHS took no action, and so the case was referred to a hearing, the claim said. That hearing was scheduled for January 2022, more than a year after Dr. Kieser stopped performing operations. But just before it happened, an agreement was reached, her attorney Sophie Purnell said. It was decided that the charges would not be prosecuted and Dr. Kieser were reinstated.

The allegations against AHS have not yet been reviewed by the Alberta Human Rights Commission. In a statement to The Globe, AHS said it was unable to comment on the matter.

dr. Kieser is the second prominent female cardiac surgeon in Canada to make such a claim.

Last year, Irene Cybulsky won a gender discrimination case against Hamilton Health Sciences after the Ontario Human Rights Tribunal concluded that gender bias had played a role in her ousting as head of the hospital network’s cardiac surgery team.

She had been the first woman in the network’s history, but lost the job after some of her male subordinates — all surgeons on the team she presided over were men — raised concerns about her leadership style, prompting an internal review. During that process, there were comments from the men that she was not gentle enough and that she was “like a mother telling her children what to do.”

The tribunal has not yet held a hearing to decide on solutions to Dr. Cybulsky.

Because there is a one-year statute of limitations for human rights complaints, the Alberta Commission will only review the most recent incidents identified in Dr. Kieser are included – mainly the events that led to her losing her surgical privileges. But the 11-page document sets out years of alleged abuse and misogyny as context for later events.

The claim describes four times when male colleagues expressed concern about Dr. voter. According to her claim, the first complaint about her technical skills was made in 2004, and an outside reviewer found no basis for the claim. In 2013, one of Dr. Kieser’s male superiors, according to the claim, took longer than her male colleagues to perform certain procedures. He would have suggested that she retire. (Dr. Kieser is now 70 years old. Her human rights complaint also alleges age discrimination.)

“Dr. Kieser explained that she uses a different surgical technique than her colleagues, which takes more time,” the claim said. (The technique involves using arterial grafts instead of vein grafts, the former of which last longer. The technique is claimed to now become standard practice.) An outside reviewer again found concerns about Dr. Kieser unfounded, according to the claim.

The claim details a third incident, in 2019, when the wife of a patient of one of Dr. Kieser asked her for help. The wife was concerned about the care her husband was receiving from a male doctor, and she asked Dr. Kieser to talk to the doctor, which Dr. Kieser did.

The man “became very hostile,” the complaint says, telling Dr. Kieser said it was unprofessional to question his concern and that she had to “be very careful”. A month later, that male doctor filed a complaint against Dr. Kieser, challenging her performance and technical capabilities. The complaint has not been considered, according to the claim.

dr. Kieser has worked at Foothills Medical Center for the past 34 years.Sarah B Groot/The Globe and Mail

From the very beginning of her time as a surgeon, Dr. Kieser in her claim, it was clear that some of her male colleagues automatically thought less of her because she was female.

For example, when she led the cardiac surgery program at Foothills Medical Center—in fact, she was the first cardiac surgeon there—all her colleagues from other specialties were referred to as “chief,” but she was addressed with a subordinate title: “coordinator.” All cardiac surgeons appointed after her were immediately referred to as “chief,” she claims in the claim.

In a response to the committee, AHS denies that Dr. Kieser has ever been discriminated against. The health service also disputes the admissibility of alleged incidents beyond the one-year statute of limitations.

In part of the response, the agency states that Dr. Kieser is not an employee of Alberta Health Services. Instead, it states that she is a physician with privileges that allow her to provide clinical services at AHS locations. (This is the employment situation for most doctors in the country. Doctors are essentially independent contractors who bill the government directly for services.)

Last year, The Globe and Mail looked at the unique challenges women face in medicine as part of a research series called Power Gap, which examined gender inequality in the workforce. Female doctors reported being pushed into less lucrative specialties than men during medical school, received fewer referrals, received less mentorship, received harsher criticism, and were questioned by both male colleagues and patients.

A Globe analysis of medical leadership at Ontario’s 10 largest hospital companies found that only 32 percent of department heads, 29 percent of department heads and 23 percent of those with prestigious research positions were women, despite the fact that the number of male and female freshmen physician assistants have been more or less equal for two decades. About 30 percent of department heads appeared to be racialized, and the numbers were similar for men and women.

In an interview, Dr. Kieser that over the years she had always felt that what was happening to her was wrong, but that it had never occurred to her to make a formal complaint. Women pay a huge price when they complain, she said.

“I thought if I just kept my head down and did my job really well, it would save the day. I felt like if I got ahead – if I wrote papers, got discovered – I might be on to this could escape, but the higher I got, the worse it got.”

When she lost her surgical privileges — and the ability to do what she loved — that, she said, was the breaking point. And not just because of the pain it caused her personally, she added, but because she was concerned about what doing nothing would mean for the next generation.

“Four of the eight cardiac surgery residents of Foothills are women. I realized that if I don’t take a stand here and say something, this could happen to them. It will never stop unless someone points out what is going on.”

In her claim, Dr. Kieser $500,000 in compensation for pain and suffering, plus reimbursement for lost wages (her attorney estimates that amount is about $480,000). She also asks that AHS be mandated to conduct education programs designed to eliminate gender, gender, and age discrimination within the cardiac surgery department.

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