J. Widdifield, PhD, ICES, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario;
J.M. Gatley, MPH, V. Ling, MSc, ICES, Toronto, Ontario.
J Rheumatol. 2021 Jul;48(7):1090-1097. doi: 10.3899/jrheum.201166. Epub 2020 Dec 1.
To compare differences in clinical activity and remuneration between male and female rheumatologists and to evaluate associations between physician gender and practice sizes and patient volume, accounting for rheumatologists' age, and calendar year effects.
We conducted a population-based study in Ontario, Canada, between 2000 to 2015 identifying all rheumatologists practicing as full-time equivalents (FTEs) or above and assessed differences in practice sizes (number of unique patients), practice volumes (number of patient visits), and remuneration (total fee-for-service billings) between male and female rheumatologists. Multivariable linear regression was used to evaluate the effects of gender on practice size and volume separately, accounting for age and year.
The number of rheumatologists practicing at ≥ 1 FTE increased from 89 to 120 from 2000 to 2015, with the percentage of females increasing from 27.0% to 41.7%. Males had larger practice sizes and practice volumes. Remuneration was consistently higher for males (median difference of CAD $46,000-102,000 annually). Our adjusted analyses estimated that in a given year, males saw a mean of 606 (95% CI 107-1105) more patients than females did, and had 1059 (95% CI 345-1773) more patient visits. Among males and females combined, there was a small but statistically significant reduction in mean annual number of patient visits, and middle-aged rheumatologists had greater practice sizes and volumes than their younger/older counterparts.
On average, female rheumatologists saw fewer patients and had fewer patient visits annually relative to males, resulting in lower earnings. Increasing feminization necessitates workforce planning to ensure that populations' needs are met.
比较男女风湿病医生之间的临床活动和薪酬差异，并评估医生性别与实践规模和患者量之间的关联，同时考虑到风湿病医生的年龄和日历年度效应。
我们在加拿大安大略省进行了一项基于人群的研究，时间范围为 2000 年至 2015 年，确定了所有全职当量（FTE）或以上的风湿病医生，并评估了男女风湿病医生之间的实践规模（就诊患者人数）、实践量（就诊患者人次）和薪酬（总按服务收费计费）的差异。使用多变量线性回归分别评估性别对实践规模和量的影响，同时考虑年龄和年份。
2000 年至 2015 年，至少从事 1 个 FTE 工作的风湿病医生人数从 89 人增加到 120 人，女性比例从 27.0%增加到 41.7%。男性的实践规模和实践量较大。男性的薪酬始终较高（每年中位数差异为 CAD 46,000-102,000）。我们的调整分析估计，在给定年份，男性平均比女性多看 606（95%CI 107-1105）名患者，多进行 1059（95%CI 345-1773）次就诊。在男性和女性中，每年就诊患者的平均数量略有但具有统计学意义的减少，中年风湿病医生的实践规模和量大于年轻/年长的同行。
平均而言，与男性相比，女性风湿病医生每年就诊的患者人数和就诊次数较少，导致收入较低。女性人数的增加需要进行劳动力规划，以确保满足人群的需求。
