A recent study published in the American Journal of Ophthalmology investigated sex disparities in ophthalmologists according to operating room (OR) time and case volumes.
Give me some background first.
Although gender equality in medicine has progressed considerably in modern times, recent studies have demonstrated that there is still significant room for improvement in this regard.
Case in point: Previous research found that—between 2005 and 2015—women accounted for only 23% of practicing ophthalmologists.
Further, a 15.6% pay gap between male and female ophthalmologists was discovered, even after accounting for work days, years in practice, and specialty.
Now, talk about the study.
To provide a greater understanding of the gender inequalities in medicine, investigators compared OR time between male and female comprehensive cataract surgeons using a retrospective, population-based cohort study in Ontario, Canada.
Secondary outcome measures included number of surgeons and average cataract surgery case volumes, categorized by sex and career stage.
Who was included in the study?
Researchers studied physician billing data from the Ontario Health Insurance Plan (OHIP) of active surgeons between 2010 and 2019.
Included were comprehensive cataract surgeons who met the following criteria
- Used the OHIP billing code E140 on at least one adult patient
- Had no other surgical subspecialties according to billing data
How were career stages defined?
The career stages of physicians was identified as follows:
- Early-career: Less than 45 years old
- Middle-career: 45 to 55 years old
- Late-career: Over 55 years old
OR utilization was determined by calculating the number of OR days per ophthalmologist per year.
Findings?
Across career stages and years, female surgeons averaged 12.45±1.90 fewer OR days per year than their male counterparts, which was one fewer day every month.
Female and male surgeons performed a similar number of case volumes per OR day, averaging 12.4±0.87 and 12.8±0.64 respectively. Despite this, male surgeons completed 172.7±30.6 more surgeries every year.
Tell me more.
The proportion of female cataract surgeons increased by 7% overall, suggesting a future of greater gender equality in the future of ophthalmology. However, this group still comprised only 24.4% of all comprehensive cataract surgeons.
Despite the increase in female cataract surgeons, the disparity in OR time remains unchanging.
This could potentially highlight the difficulties women may face in obtaining OR time— especially in early stages of their careers.
Expert opinion?
The study authors stated: “Overall, the utilization of OR time is controversial and may be related to sex disparities in income.”
Anything else?
The reduced number of case volumes received by female cataract surgeons may also play a role in the pay disparity amongst comprehensive cataract surgeons, though more research is needed to confirm.
Limitations?
A few… though the vast majority of included surgeons were active, it is possible that some inactive surgeons may have been included due to the inclusion criteria.
Because cataract surgeries performed by surgeons with other subspecialties were excluded, the generalizability of the findings is limited.
Take home.
The findings of this study suggest that OR time may be linked to the income gap in male and female ophthalmologists, as observed in this sample of comprehensive cataract surgeons.
Greater transparency regarding OR utilization is necessary to combat sex disparities in income.