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Yvonne M Buys, Jonathan A Micieli; Proportion of Medical Only versus Surgical Ophthalmology Practices: Associations and Trends. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5569.
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© ARVO (1962-2015); The Authors (2016-present)
Ophthalmology is one of the few unique specialties in medicine that provides the opportunity for primarily medical, primarily surgical or combined medical and surgical practice however, it remains unknown what proportion of ophthalmologists have surgical vs medical only practices. The goal of this study was to assess the yearly proportion of ophthalmologists with a medical only practice over a 14-year period and the influence of gender and career stage.
Retrospective population-based study in Ontario, Canada, a universal government funded healthcare system. Individual ophthalmologists’ yearly billings, gender and year of medical school graduation were accessed via the Medical Services database in IntelliHEALTH Ontario from 1999-2013. A surgical ophthalmologist was defined as one who performed 20 or more ophthalmological surgical procedures. The yearly proportion of medical only vs surgical ophthalmologists was obtained. The effect of gender and career stage (early (<10 years from graduation), mid (10-45 years) and late-career (>45 years)) was evaluated. In addition, productivity of medical versus surgical ophthalmologists was compared based on number of consultations and assessments.
The number of practicing ophthalmologists in Ontario increased from 410 in 1999 to 469 in 2013. The proportion of medical only versus surgical ophthalmologists changed little over the 14-year period, averaging 30.5% medical only and 69.5% surgical. Recent graduates showed a decreasing trend towards performing surgery of 1.6% per year whereas late-career ophthalmologists demonstrated an increasing trend of 1.5% per year. Female ophthalmologists were less likely to perform surgery than male ophthalmologists but showed an increasing surgical trend. Surgical ophthalmologists saw on average 1.6X the number of yearly consultations and assessments compared to their medical peers. Late-career ophthalmologists saw significantly fewer patients than their younger counterparts in each year studied.
A significant number of ophthalmologists have medical only practices. A large majority of late-career ophthalmologists have transitioned to a medical only practice. A decreasing trend in the proportion of young ophthalmologists performing surgery coincides with a growth of late-career surgical ophthalmologists which may be limiting surgical opportunities for new graduates.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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