Proportion of medical-only versus surgical ophthalmology practices: associations and trends

Abstract

ObjectiveTo investigate what proportion of ophthalmologists have medical-only practices and the influence of career stage, sex, and time. DesignPopulation-based study of medical and surgical practice patterns among all ophthalmologists in Ontario, Canada, from April 1999 to March 2013. ParticipantsAll active ophthalmologists in Ontario, Canada, providing universal health care for the provincial population of approximately 13 million. MethodsThe IntelliHealth database operated by the Ministry of Health and Long Term Care, which has excellent accuracy for procedure performance, was used to obtain anonymized physician services. Ophthalmologists were categorized as surgical or medical-only based on billing claims data. ResultsThe 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 toward 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. Ophthalmologists performing surgery saw on average 1.6 times the number of yearly consultations and assessments than their medical peers. Late-career ophthalmologists saw significantly fewer patients than their younger counterparts in each year studied. ConclusionsA significant number of ophthalmologists have medical-only practices. The 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.