Yvonne M Buys1, Mayilee Canizares2, Tina Felfeli3, Yaping Jin4. 1. Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada. Electronic address: y.buys@utoronto.ca. 2. The Arthritis Program, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada. 3. Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada. 4. Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Abstract
PURPOSE: To compare the effect of age, sex and generation on physician practice patterns in Ontario, Canada. DESIGN: Retrospective cohort study. METHODS: Physician and patient data from 1992 to 2013 were used to calculate yearly number of physicians, distinct patients seen, patient visits, government payments, physician age, sex, specialty, and year of birth. Age-period-cohort models were used for analysis. RESULTS: There was a negligible change in the number of distinct patients for all physicians and family physicians and a 20.6% decrease for ophthalmologists. There were small declines in yearly visits for all physicians (14.2%) and family physicians (17.3%) and a 10.0% increase for ophthalmologists. There was a lower number of visits (and patients for ophthalmologists) in each succeeding recent birth cohort. For all groups and birth cohorts, male physicians had significantly greater number of visits and patients. Median payments increased over time in all groups and were less for women with an average women-to-men ratio of 0.64 for all physicians, 0.75 for family physicians, and 0.59 for ophthalmologists. After adjusting for the number of visits and patients, sex differences in payments remained significant for all physicians and ophthalmologists but were no longer significant for family physicians. CONCLUSION: Younger cohorts of Ontario physicians have greater yearly payments compared to older cohorts at the same age despite similar or slightly fewer numbers of visits and patients. The sex gap of payments was mostly explained by differences in the number of patients and visits for family physicians, but remained significant for all physicians and ophthalmologists.
PURPOSE: To compare the effect of age, sex and generation on physician practice patterns in Ontario, Canada. DESIGN: Retrospective cohort study. METHODS: Physician and patient data from 1992 to 2013 were used to calculate yearly number of physicians, distinct patients seen, patient visits, government payments, physician age, sex, specialty, and year of birth. Age-period-cohort models were used for analysis. RESULTS: There was a negligible change in the number of distinct patients for all physicians and family physicians and a 20.6% decrease for ophthalmologists. There were small declines in yearly visits for all physicians (14.2%) and family physicians (17.3%) and a 10.0% increase for ophthalmologists. There was a lower number of visits (and patients for ophthalmologists) in each succeeding recent birth cohort. For all groups and birth cohorts, male physicians had significantly greater number of visits and patients. Median payments increased over time in all groups and were less for women with an average women-to-men ratio of 0.64 for all physicians, 0.75 for family physicians, and 0.59 for ophthalmologists. After adjusting for the number of visits and patients, sex differences in payments remained significant for all physicians and ophthalmologists but were no longer significant for family physicians. CONCLUSION: Younger cohorts of Ontario physicians have greater yearly payments compared to older cohorts at the same age despite similar or slightly fewer numbers of visits and patients. The sex gap of payments was mostly explained by differences in the number of patients and visits for family physicians, but remained significant for all physicians and ophthalmologists.
Authors: Mitch Steffler; Nadine Chami; Samantha Hill; Gail Beck; Stephen C Cooper; Robert Dinniwell; Sarah Newbery; Sarah Simkin; Brittany Chang-Kit; James G Wright; Jasmin Kantarevic; Sharada Weir Journal: JAMA Netw Open Date: 2021-09-01
Authors: Zamir Merali; Armaan K Malhotra; Michael Balas; Gianni R Lorello; Alana Flexman; Tara Kiran; Christopher D Witiw Journal: CMAJ Date: 2021-10-18 Impact factor: 8.262