Profiles of Practicing Female Orthopaedists Caring for Medicare Patients in the United States.

BACKGROUND

The increase in the percentage of women in orthopaedics in the United States over the last half century has been substantially slower than in every other surgical specialty. While this percentage has improved recently, the current demographic and practice characteristics of female orthopaedic surgeons are not well known. This study defines the landscape of practicing female orthopaedic surgeons caring for Medicare patients.

METHODS

Publicly available Medicare billing data sets from 2012 to 2014 were utilized to identify practicing orthopaedic surgeons. We analyzed demographics, medical training, practice characteristics, case volume, specialization, and procedure profiles of orthopaedic surgeons. Representative Current Procedural Terminology (CPT) codes were utilized for each subspecialty. Multivariate analysis was performed to confirm the independent characteristics that were associated with female orthopaedic surgeons after identification by univariate statistics.

RESULTS

The percentage of practicing female orthopaedic surgeons caring for Medicare patients increased significantly from 4.7% (1,043 of 22,038) in 2012 to 5.2% (1,179 of 22,510) in 2014. Women had graduated from medical school in more recent years than men (mean, 14.9 versus 22.5 years, respectively; p < 0.001), and were more likely to have attended a top-25 medical school (27.5% versus 24.5%, respectively; p = 0.01). Women were more likely to be part of larger practices (median, 49.5 versus 24 partners, respectively; p < 0.001), and were more likely to leave practice (4.4% versus 3.1% in 2013, respectively; p = 0.02). Women submitted fewer claims for billing per year (median, 528 versus 1,193, respectively; p < 0.001), and performed 6.8% (9,852 of 144,492) of hand procedures compared with 1.5% (10,043 of 651,856) of all other common procedures (p < 0.001). Multivariate analysis demonstrated that despite confounders, gender was an independent predictor of number of claims, the likelihood of leaving clinical practice, and Medicare reimbursement.

CONCLUSIONS

There are significant differences between female and male orthopaedic surgeons caring for Medicare patients in terms of subspecialty choices, education, billing practices, and attrition rates. Despite the recent increase in the number of female orthopaedic surgeons, there are significant gender differences within the specialty.