A comparative analysis of the practice profile of ophthalmology to other surgical specialities in Canada
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Authors: Elizabeth Y. Lee, Jason Noble, Nirojini Sivachandran
Author Disclosure Block: E.Y. Lee: None. J. Noble: None. N.
Sivachandran: None.
Abstract Body:
Purpose: To compare the practice patterns and working
conditions of ophthalmologists to other surgical specialists in Canada.
Study Design: Cross-sectional survey study.
Methods: Data regarding specialty surgeons’ working conditions were
extracted from the 2017 CMA Work Force Survey, a national survey of practicing
physicians in Canada. Basic statistical analyses including chi-square analyses
and t-tests, were used to compare the responses of ophthalmologists to other
surgical disciplines using MedCalc® (Ostend, Belgium: MedCalc Software).
Results: Compared to other surgeons, ophthalmologists saw
significantly more patients weekly excluding call (144 vs 70 patients,
p<0.01, t-test). Ophthalmologists were more likely to provide same day
urgent care services (77.0% vs. 30.8%, p<0.01, Chi-squared), despite a lower
overall percentage reporting the provision of formal on-call duties (73.6% vs
85.4%, p<0.01 Chi-squared) and less formal on-call hours per week (110 vs
142 hours, p=0.02, t-test). There were no differences in the self-reported
satisfaction in access to OR, procedural rooms, elective procedures and
diagnostic tests between ophthalmology and other surgical specialties.
Ophthalmologists tended to report feelings of being overworked more often than
other surgeons (44.7% vs. 31.4%, p=0.01, Chi-squared). There was no statistical
difference in professional life and work-life balance satisfaction between
respondents in ophthalmology and other surgical specialties. Most
ophthalmologists (92.5%) worked in a fee-for-service (FFS) model, whereas other
surgeons had a mixture of FFS (67.9%) and blended (22.8%) models (p<0.01,
t-test). Ophthalmologists reported a higher proportion of their income used for
overhead compared to other surgeons (39.6% vs. 25.9%, p<0.01, Chi-squared).
Conclusions: The practice profiles and work patterns of
ophthalmologists differ from those of other surgeons in Canada. Some of the
differences in provision of on-call series may be due to the fact that
ophthalmologists often see emergency cases in their private offices as opposed
to an in-hospital setting. Although majority of ophthalmologists reported
satisfaction with their professional life and work-life balance, the high
percentage of respondents feeling overworked may contribute to physician
burnout over the long-term.