Advocating for Yourself: In Compensation and in Health

Stephanie and Veronica, the founders of CAYA Health Centre, sat down with Jillian and Sophie from The Thoughtful Co to discuss inequities in compensation and inequities within the healthcare system for those who are marginalized based on gender.

Written By: Jillian Climie

Something that is central to The Thoughtful Co is supporting women in advocating for themselves in the workplace. Since we started our company a year and a half ago, we’ve also realized how fundamental this mindset is in our client’s everyday lives as well. One area that this is especially crucial: mental and physical health. To learn more about advocating for ourselves in this area, we sat down with Stephanie Dang (Registered Dietitian) and Dr. Veronica Li (Registered Clinical Counsellor), co-founders of Come As You Are (CAYA) Health Centre, a multidisciplinary clinic located in Vancouver BC, focused on supporting women, trans, and non-binary peoples’ health.

We work with our clients to support them in advocating for the compensation they deserve. How do you find that advocating for yourself applies to mental and physical health?

Before CAYA, we each had our own practices and we noticed there was a gap in the healthcare system for women, racialized people, and those in the 2SLGBTQIA+ community. There was a lack of follow-through and so many had to advocate to get the support they needed – for example, getting blood work for hormonal issues or seeking support for sexual pain. A lot of women’s pain is diagnosed as psychological and often their symptoms can be diminished or overlooked. This can be incredibly tough for women who are already discouraged to ask for support.

Women need to know that they are the experts of their own bodies. We need to trust ourselves and speak up for ourselves. Bias still exists, and is not excluded from the healthcare system. For example, the majority of clinical trials have been done on men, and then just applied to women’s health. It doesn’t always fit. Don’t feel nervous to ask questions.

What recommendations do you have for women as they navigate advocating for themselves in the healthcare system?

It can be hard to know how to advocate for yourself – what to ask for, where to start. Making sure you feel comfortable with your service providers is a great first step. Know that you can evaluate them. Meet them first, and see if it’s a good fit for you. You can also look on websites to see if the provider specializes in the support you might need, or has the experience you’re looking for. Having a practitioner you trust will hopefully ease some of the distress that can come with accessing care, especially around topics like mental and sexual health. We also believe that we need to start talking about these topics more – sharing resources, clinics, stories, challenges, etc. – and continuing to ask questions. We’re in a better place than we used to be, but there’s still a long way to go.

Did some of these factors lead you to starting your own clinic?

Absolutely. We wanted to build a multi-disciplinary clinic that women and gender diverse people can go to for all their needs and have a community they trust – including a psychologist, counsellor, dietitian, massage therapist, general practitioner, physiotherapist, and pelvic floor physiotherapist. We’ve heard the same struggles from so many of our clients and even noticed it amongst ourselves and how we interact with the healthcare system. We wanted to be part of a positive support system for those who have been typically underserved in healthcare, and help them find the root causes of their issues instead of only focusing on the treatment symptoms.

As small business owners, how has advocating for yourself applied to your own fees and rates?

When you’re in the public sector, compensation is very standard, with increases each year and standard benefits. For myself [Stephanie], leaving the public sector to work at a private sector company was the first time there was room for negotiation, but I didn’t negotiate. It was so new to me and it didn’t even really cross my mind, although now I realized I should have.

Now that we’re starting our own clinic, it’s tempting to offer our services for discounted rates or for free, given so much of what we do is about supporting people. We get asked to do free workshops all the time and it’s hard to say no when we want to help. Some of our service providers have “suggested charge rates” which helps keep pay relatively standard (e.g., counsellors). Doctors also have very structured fees, although we know the compensation structures aren’t necessarily working. We also know there’s research showing that female doctors stay longer with their patients even though they’re not getting paid for that time. Overall, we are learning the importance of setting structured rates and fees to ensure we are fairly compensating our practitioners for their time, and building a sustainable clinic over the long-term.

What internal or external barriers have you had to go through in starting this clinic and ensuring you’re charging what you deserve?

As two women starting a small business, we spent a lot of time researching resources for us to access support. Funding this project seemed intimidating at first, but the resources at the Women’s Enterprise Centre really helped us. We also leaned heavily on our community to help us navigate elements such as property rental and construction. A challenge we experienced was not knowing what the general rates were for certain services and at times, feeling that this was used against us. We are curious about the potential implicit bias that could have an impact on young women starting a small business. Once our health center is open, we hope to find a balance between fairly compensating practitioners for their time and providing accessible services to those in need.

How will you ensure you’re holding true to your rates and fees?

We want to set boundaries and ensure we’re holding each other accountable. Regular communication about finances is going to be crucial. We know the importance of valuing our own time, and we want to honour this to keep the clinic running over the long-term.

If you want to check out Stephanie and Veronica’s new clinic CAYA Health Centre, please follow along on Instagram @cayahealthcentre and online at www.cayahealthcentre.com. And if you’d like support with advocating for yourself in terms of compensation, please reach out to The Thoughtful Co at contact@thethoughtfulco.net or sign up for a one-on-one session here – we would love to support.