Practice patterns of Canadian glaucoma specialists: planning for the next generation

Abstract

Background: To identify practice patterns of Canadian glaucoma specialists in order to begin identifying the needs of the work force to care for the next generation of glaucoma patients.Methods: Survey of 130 Canadian glaucoma specialists whose names were obtained from the Canadian Ophthalmological Society specialist list.Results: The response rate was 62% (81/130); 77% (62/81) considered themselves glaucoma specialists, but only 77% (48/62) of these had at least 1 year of formal glaucoma training. Specialists had a mean of 6.4 half days per month in the operating room, devoting the majority of their surgical time to glaucoma but performing more cataract surgery than glaucoma surgery. Forty percent of glaucoma specialists do not perform glaucoma drainage implant surgery.All the respondents stated that wait time for emergency care was within hours, but only 21% could perform their nonurgent cases within the benchmark set in this study of 4 weeks, wait times averaging 9.2 (range: 3–24) weeks. Forty-eight percent of the glaucoma specialists were not satisfied with their mix of clinical, laser, surgery, and nonophthalmology activities. Forty-four percent plan to decrease their clinical load over the next 5 years: 23% plan to increase their teaching, 19% their research, and 35% plan to devote less time to ophthalmology over the next 5 years.Interpretation: Forty-eight percent of glaucoma specialists had concerns regarding timely intervention for semiurgent care, in that only 21% of these cases are performed within 1 month of a confirmed need for surgery.With a benchmark that surgery be performed within 1 month in patients whose glaucoma is progressing despite medical, laser, or prior incisional surgical care, we do not have adequate resources to care for current glaucoma needs.With the aging population and ongoing attrition of ophthalmologists, we need to plan for improved access to glaucoma surgery.