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Rana Greene, Yaping Jin, Ying Qi, Yvonne M Buys; Influence of gender and age on ophthalmologists’ billings from 1992-2014. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5577.
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© ARVO (1962-2015); The Authors (2016-present)
Physician resource management requires knowledge not only of headcounts but also capacity of care which is commonly reported as Full Time Equivalents (FTEs). Given the documented feminization of the ophthalmology workforce and the 7-fold increase in Canadian ophthalmologists aged ≥65 years since 1970, this study evaluated the influence of gender and age on billing patterns as a surrogate of capacity of care.
Yearly Ontario Health Insurance Plan (OHIP) billings of all Ontario ophthalmologists from 1992-2014 were obtained from the Institute for Clinical Evaluative Sciences for this retrospective cohort study. Comparisons in yearly billings were made between genders and among all age groups using 5 year increments. For comparison similar data was evaluated for all Ontario physicians. Billing data was adjusted to 2014 Canadian dollars to account for inflation.
Median billings for ophthalmologists changed little from 1992-2005, then increased 1.8% yearly peaking in 2011 followed by a 4.5% decrease to 2014. For all Ontario physicians median billings decreased 0.67% yearly from 1992-2014. Median billings of female ophthalmologists were less than male ophthalmologists however this difference decreased over the study period with females billing 50.1% of male ophthalmologists’ in 1992 increasing to 78.2% in 2014, a 1.4% yearly increase. In comparison for all Ontario physicians the gender gap in billings changed little with female physicians’ median billings averaging 63.6% of males. In terms of age, highest billing was in the 35-54 year cohort. Although the lowest billing was in those >75, this group had the largest increase with median billings increasing 6.5X in the study period. In contrast those ≤35 were third highest billers in 2004 but second lowest from 2009-2014 with a 51% decrease in billings from 2004-2013. Those 70-74 had 115% increase in yearly median billings from 2007-2014 billing more than those ≤35 from 2009-2014.
Median billings have decreased for Ontario ophthalmologists since 2011. Female ophthalmologists are slowly bridging the gender gap with median billings increasing from 50.1% of male billings in 1992 to 78.2% in 2014. Ophthalmologists aged 35-54 had the highest yearly median billings. Median billings of ophthalmologists aged >70 have increased while those ≤35 have decreased from 2009 suggesting delayed retirement may be affecting opportunities for recent 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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