Supply and demographic characteristics of Ontario’s ophthalmologist from 2010-2019: A population-based analysis.

Authors: Aman P. Sayal, Yusuf Ahmed, Mark M. Popovic, MatthewSchlenker, Robert J. Campbell, Jasmin Kantarevic, Joanna Nadolski, Karen D’Souza, Sherif El-Defrawy

Author Disclosure Block: A.P. Sayal: None. Y. Ahmed: None. M.M. Popovic: None. M. Schlenker: None. R.J. Campbell: None. J. Kantarevic: None. J. Nadolski: None. K. D’Souza:None. S. El-Defrawy: None.

Abstract Body:

Purpose: Ophthalmologists provide most of their care to the elderly and Ontario continues to have a rapidly aging population. This has prominent human resource implications when considering that the utilization of ophthalmic services is highest amongst older individuals. Therefore, this study investigated the supply and demographic characteristics of Ontario’s ophthalmologists.

Study Design: Retrospective, population-based analysis.

Methods: Using validated healthcare databases, the supply of ophthalmologists in Ontario from 2010- 2019 within different areas of care was evaluated and reported using descriptive statistics. Cohort demographics including sex and career stage were also detailed.

Results: Over the study period, a median of 464 ophthalmologists were practicing in Ontario. The proportion of ophthalmologists who were female increased from 18.7% to 24.1% over the study period. Late-career ophthalmologists increased by 6.4% and made up 45.3% of the workforce in 2019. In 2019, 12.2% of Ontario’s ophthalmologists were 56-60 years old, 14.9% were 61-65, 8.0% were 66-70 and 10.3% were older than 70; the proportion of ophthalmologists who were 61-65 approximately doubled over the study period while the other late-career cohorts remained comparatively stable. Comprehensive cataract surgery was the most common area of care (yearly median=199). While the number of ophthalmologists/100,000 people remained stable over the study period (3.27 ophthalmologists/100,000 people in 2019),the number of ophthalmologists/100,000 people65 years of age and older fell by 18.4%. Moderate-volume comprehensive cataract surgeons experienced the greatest supply reduction (-20.2%; -35.4% relative to the population 65 and over). While all subspecialties had at least some growth relative to the overall population, 4/7 areas of care significantly declined in supply relative to the elderly cohort; retinal surgery (-16.6%) represented the greatest decrease.

Conclusions: Between 2010 and 2019, the overall number of ophthalmologists in Ontario remained stable, however, declines in the number of ophthalmologists per 100,000 individuals 65 years of age and older for most areas of care were evidenced. Nearly half of the ophthalmology workforce is now over 55 years of age and female representation in the field continues to increase.