Abstract
Purpose :
In response to demographic changes of the ophthalmology workforce in Canada, an analysis of the practice patterns of ophthalmologists over the past two decades will provide a valuable reference for physician resource management.
Methods :
The Institute for Clinical Evaluative Sciences (ICES) database was used to determine the yearly headcount, gender, median yearly OHIP billings and patient visits of Ontario-licensed ophthalmologists from 1992 to 2014 for the following age groups; <35, 35-39, 40-44, 45-49, 50-54, 55-59, 60-64, 65-70, 70-74, ≥75. All billing data were adjusted to 2014 dollars to account for inflation.
Results :
Female representation of ophthalmologists in Ontario has steadily increased from 11.1% in 1992 to 19.2% in 2014. Ophthalmologists within the 35-55 age groups represented the highest billing cohort throughout the study period. Early-career ophthalmologists in the <35 years of age group had the greatest variability in their yearly median billings, with the largest pay discrepancy between males and females of 89.1% in 1992 and smallest of 9.15% in 2014. The later-career ophthalmologists in the 40-44 age group showed a 72.2% billing difference between males and females in 1992 compared to 19.9% in 2014, while showing the smallest changes in billing patterns over time. Gender differences in billing within the 35-39, 40-45 and 50-54 age groups continued to narrow, such that in 2014, females earned 26.6%, 19.9% and 27.8% less than males, respectively. Despite narrowing gaps seen in these age groups, women of 45-49 years of age earned 49.9% less than males in 2014. Male ophthalmologist had 2.7% more patient visits than females in the <35 age group, however greater discrepancies were seen in later-career ophthalmologists, where females in 35-39, 40-44, 45-49, 50-54 age groups saw 8.8%, 28.3%, 39.8% and 10.8% fewer patients, respectively.
Conclusions :
Gaps in billing trends continue to exist across all age groups and gender with women billing less than their male counterparts. Complex differences in practice patterns of ophthalmologists by age groups affects both workforce planning and highlight the need for a better understanding of changing characteristics relating to aspects of work–life balance and access to resources.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.