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Cote SL, Nguyen A, Berry JL, Reid M, Chang J, Chen J, Nguyen A, Chang MY. Gender Disparities in Mentorship and Career Outcomes in Ophthalmology. J Womens Health (Larchmt) 2024; 33:1120-1127. [PMID: 38634534 DOI: 10.1089/jwh.2023.0876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024] Open
Abstract
Background: Gender disparities in the field of ophthalmology have been increasingly recognized. Although mentorship has been proposed as a contributing factor, there are limited data on the differences in mentorship experiences by gender among ophthalmologists. Objective: The purpose of this study was to evaluate gender disparities in mentorship experiences among ophthalmologists, and the impact of mentorship disparities on career outcomes. Design: Prospective, cross-sectional study. Setting: Web-based survey distributed through ophthalmology listservs. Participants: Ophthalmologists and ophthalmologists-in-training who completed the survey. Exposure: Training and practicing in the field of ophthalmology. Main Outcome Measures: Mentorship score based on 10 items from a previously published scale of mentorship quality and self-reported career outcomes (income, job satisfaction, achievement of career goals, and support to achieve future career goals). Results: We received survey responses from 202 male and 245 female ophthalmologists. Female ophthalmologists reported significantly lower mentorship satisfaction and worse quality of mentorship (p < 0.03). Female ophthalmologists also reported significantly lower income, worse job satisfaction, and lower rates of goal achievement and support to achieve future goals; all of these career outcomes, except income level, were partly mediated by mentorship score (mediation effect ranged from 29% to 68%, p < 0.014). Conclusions and Relevance: Gender-based inequities in achievement of career goals and job satisfaction are partly mediated by disparities in mentorship. Therefore, focused mentorship of women in ophthalmology at all career stages is imperative to reduce these inequities.
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Affiliation(s)
- Stephanie L Cote
- Division of Ophthalmology, The Vision Center at the Children's Hospital Los Angeles, Los Angeles, California, USA
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Angeline Nguyen
- Division of Ophthalmology, The Vision Center at the Children's Hospital Los Angeles, Los Angeles, California, USA
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Jesse L Berry
- Division of Ophthalmology, The Vision Center at the Children's Hospital Los Angeles, Los Angeles, California, USA
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Mark Reid
- Division of Ophthalmology, The Vision Center at the Children's Hospital Los Angeles, Los Angeles, California, USA
| | - Jessica Chang
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Jenny Chen
- Kaiser Permanente, Oakland, California, USA
| | - Annie Nguyen
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
| | - Melinda Y Chang
- Division of Ophthalmology, The Vision Center at the Children's Hospital Los Angeles, Los Angeles, California, USA
- Roski Eye Center, University of Southern California, Los Angeles, California, USA
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Botchway-Commey E, Muscara F, Greenham M, D'Cruz K, Bonyhady B, Anderson V, Scheinberg A, Knight S. Rehabilitation models of care for children and youth with traumatic brain and/or spinal cord injuries: A focus on service structure, service organization, and the barriers and facilitators of rehabilitation service provision. Neuropsychol Rehabil 2023; 33:1697-1727. [PMID: 36423210 DOI: 10.1080/09602011.2022.2147196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/08/2022] [Indexed: 11/25/2022]
Abstract
To understand the systems underlying current rehabilitation models of care used with children and youth (0-21years) who sustain traumatic brain and/or spinal cord injuries. This study gathered qualitative data on service structures, service organization, and the barriers and facilitators of service provision in selected medical rehabilitation service(s) (MRS) and community-based rehabilitation service(s) (CBRS). Informants from 11 rehabilitation services were interviewed using a semi-structured interview guide. Interviews were analysed in NVivo using content analysis method. Experiences shared by the service representatives indicated that most services supported children and youth with brain injury, with a limited number also specializing in spinal cord injuries. MRS often delivered care in inpatient or outpatient settings, while CBRS offered home/community-based services. Care planning often started either prior to or shortly after admission from acute care settings, using either multidisciplinary or interdisciplinary teamwork models. Strengths of the services included innovation and provision of family-centred care; while challenges experienced included difficulty translating evidence into practice and poor team communication. Models of care were similar across services, with a focus on providing family-centred care. Several shared challenges were described, and service representatives expressed interest in forming partnerships and collaborations to address these challenges through innovative initiatives.
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Affiliation(s)
- Edith Botchway-Commey
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
| | - Frank Muscara
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Mardee Greenham
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
| | - Kate D'Cruz
- Department of Occupational Therapy, Social Work and Social Policy, School of Allied Health, Human Services and Sport, College of Science, Health and Engineering, La Trobe University, Melbourne, Australia
| | - Bruce Bonyhady
- Melbourne Disability Institute, University of Melbourne, Melbourne, Australia
| | - Vicki Anderson
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
| | - Adam Scheinberg
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
- Victorian Paediatric Rehabilitation Service, Parkville, Australia
| | - Sarah Knight
- Brain and Mind, Clinical Sciences, Murdoch Children's Research Institute, Parkville, Australia
- The Royal Children's Hospital, Parkville, Australia
- Department of Paediatrics, The University of Melbourne, Melbourne, Australia
- Department of Paediatrics, Monash University, Melbourne, Australia
- Victorian Paediatric Rehabilitation Service, Parkville, Australia
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Barequet IS, Rosenblatt A, Schaap Fogler M, Pedut-Kloizman T, Gaton D, Loewenstein A, Habot-Wilner Z. Gender related trends among Israeli ophthalmologists professional career and personal life performance. Eye (Lond) 2023; 37:3496-3501. [PMID: 37106146 PMCID: PMC10630451 DOI: 10.1038/s41433-023-02543-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/17/2023] [Accepted: 04/13/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Gender-diversity trends in ophthalmology in Israel have not been studied despite a high proportion of female ophthalmologists. Our purpose was to evaluate gender-related trends in ophthalmology professional career and personal life performance in early and advanced careers in Israel. METHODS A survey based on a nationwide voluntary anonymous web questionnaire was distributed to the members of the Israeli Ophthalmological Society. The questionnaire included questions referring to professional career and personal life performance. Gender differences were analyzed. RESULTS Out of 252 respondents, 116 (46%) were women, with a mean age of 47.97 + -11.3 and 53.18 + -12.4 (P = 0.01) years, respectively. Marital status, post-residency fellowship performance or duration, an additional academic degree, academic appointments, and managerial positions were similar between genders. Fellowship predominance of males was found in cornea/cataract/refractive and of females in strabismus, pediatric ophthalmology, and neuro-ophthalmology (P < 0.01, P = 0.032, respectively). Men had significantly more publications and appointments in peer review journals and work hours (P = 0.04 and P = 0.02, P = 0.027, respectively). Both genders responded similarly regarding work satisfaction, combination between family life and work. More women felt inequity during and post-residency in clinical (P = 0.011, P = 0.001, respectively) and surgical work (P = 0.001, P = 0.035, respectively). More women experienced inappropriate remarks from patients and sexual harassment (P = 0.001, P < 0.001, respectively), and supported the need for affirmative action (P < 0.0001). CONCLUSIONS Several gender disparities were found among ophthalmologists in Israel, including subspecialties distributions, publications, appointments in peer review journals, working hours, work inequity sense, harassment events, and support the need for affirmative action.
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Affiliation(s)
- Irina S Barequet
- Goldschleger Eye Institute, Sheba Medical Center, Ramat Gan, Israel.
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Amir Rosenblatt
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Michal Schaap Fogler
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | | | - Dan Gaton
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Ophthalmology, Rabin Medical Center, Petach Tikva, Israel
| | - Anat Loewenstein
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Zohar Habot-Wilner
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Abstract
OBJECTIVE The objective of this study is to systematically synthesize the existing literature on the experiences of motherhood in female surgeons both during surgical training and as staff physicians, to identify knowledge gaps, and to provide recommendations for institutional changes to better support pregnant female surgeons. BACKGROUND There are disproportionately fewer medical students pursuing surgical specialties, as surgery is often seen as incompatible with childbearing and pregnancy. However, no review has summarized the published literature on the collective experiences of female surgeons in navigating motherhood. METHODS Four databases were searched and 1106 abstracts were identified. Forty-two studies were included and a thematic analysis was performed. RESULTS Four themes were identified: path toward motherhood (n=18), realities of motherhood (n=25), medical culture and its impact on career and family life (n=24), and institutional reproductive wellness policies (n=21). Female surgeons are more likely to delay motherhood until after training and have high rates of assisted reproductive technology use. Pregnancy during surgical training is associated with negative perception from peers, pregnancy complications, and scheduling challenges. Maternity leave policies and breastfeeding and childcare facilities are variable and often inadequate. Many female surgeons would agree that greater institutional support would help support women in both their roles as mothers and as surgeons. CONCLUSIONS Both female residents and staff surgeons experience significant and unique barriers before, during, and after motherhood that impact their personal and professional lives. Understanding the unique challenges that mothers face when pursuing surgical specialties is critical to achieving gender equity.
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Considerations for Training and Workforce Development to Enhance Rural and Remote Ophthalmology Practise in Australia: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148593. [PMID: 35886446 PMCID: PMC9315488 DOI: 10.3390/ijerph19148593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/05/2022] [Accepted: 07/07/2022] [Indexed: 11/11/2022]
Abstract
Australia has one of the lowest per capita numbers of ophthalmologists among OECD countries, and they predominantly practise in metropolitan centres of the country. Increasing the size and distribution of the ophthalmology workforce is of critical importance. The objective of this review was to investigate the context of rural ophthalmology training and practise in Australia and how they relate to future ophthalmology workforce development. This scoping review was informed by Arksey and O’Malley’s framework and the methodology described by Coloqhuon et al. The search yielded 428 articles, of which 261 were screened for eligibility. Following the screening, a total of 75 articles were included in the study. Themes identified relating to rural ophthalmology training and practise included: Indigenous eye health; access and utilisation of ophthalmology-related services; service delivery models for ophthalmic care; ophthalmology workforce demographics; and ophthalmology workforce education and training for rural and remote practise. With an anticipated undersupply and maldistribution of ophthalmologists in the coming decade, efforts to improve training must focus on how to build a sizeable, fit-for-purpose workforce to address eye health needs across Australia. More research focusing on ophthalmology workforce distribution is needed to help identify evidence-based solutions for workforce maldistribution. Several strategies to better prepare the future ophthalmology workforce for rural practise were identified, including incorporating telehealth into ophthalmology training settings; collaborating with other health workers, especially optometrists and specialist nurses in eyecare delivery; and exposing trainees to more patients of Indigenous background.
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An Eye on Gender Equality: A Review of the Evolving Role and Representation of Women in Ophthalmology. Am J Ophthalmol 2022; 236:232-240. [PMID: 34283980 DOI: 10.1016/j.ajo.2021.07.006] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 07/03/2021] [Accepted: 07/05/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE In recent decades, women have achieved greater representation in ophthalmology. Globally, women now constitute approximately 25%-30% of ophthalmologists and 35%-45% of trainees. Nevertheless, women remain under-represented in key areas, including positions of professional and academic leadership and ophthalmic surgical subspecialization. Furthermore, there is evidence that women in ophthalmology encounter more bias and discrimination across multiple domains than men, including a gender-pay gap that is wider than in many other surgical subspecialties. Women ophthalmologists and trainees report sharply differing training experiences from male peers, including fewer opportunities to operate, more bullying and harassment, less access to mentorship, and contrasting expectations around contributions to family life. DESIGN Perspective. METHODS An extensive literature search was undertaken to compile and review papers published with a focus on gender equity across ophthalmology, surgery, and medicine. RESULTS We identified 8 broad domains that were widely discussed: leadership, research and academics, income, surgical exposure and subspecialization, harassment, career satisfaction, mentorship, and family and marital differences. We have summarized the current research across each of these areas, and discussed possible solutions to reduce the inequities reported. CONCLUSIONS This review draws on current research published around representation and experiences of women in ophthalmology and suggests that there are opportunities to improve gender inequity.
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Rattan SA, Mutashar MK, AnNasseh MG, Al-Attar Z. Obstacles and Challenges Facing Iraqi Women Ophthalmologists. Middle East Afr J Ophthalmol 2022; 29:80-84. [PMID: 37123428 PMCID: PMC10138133 DOI: 10.4103/meajo.meajo_87_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 10/07/2022] [Accepted: 12/14/2022] [Indexed: 05/02/2023] Open
Abstract
PURPOSE The purpose of this study was to address disparities between male and female Iraqi ophthalmologists in terms of personal circumstances, professional profiles, and attitudes toward work and family life. METHODS A Google Form-based questionnaire was released on a social media platform including 500 ophthalmologists between September 1, and December 1, 2021. The survey included three domains: (1) demographic characteristics, (2) clinical practice profile, and (3) career satisfaction and work/family balance. RESULTS The study included a total of 209 specialists, with a response rate of 45.5%. About 69.4% of them were 45 years and younger. The female-to-male ratio was 1:1.6, 188 (90%) were married and 186 (88.9%) had children. Women ophthalmologists worked fewer hours, days, and operations than male ophthalmologists (P = 0.091). Moreover, women ophthalmologists in private practice were considerably underrepresented. General ophthalmologists represented 77%. The number of women ophthalmologists with subspecialty degrees was far less 9 (11.5%) than males 38 (29.2%), P = 0.003, and they performed significantly fewer operations than male ophthalmologists (P = 0.001). Family duties were the biggest deterrent for female ophthalmologists. For males, the private clinic is an obstacle to acquiring a specialty degree in 45.6%, but for women, it is just 25.7%. Overall satisfaction was 65.1%. Women respondents were less satisfied with their practice (P = 0.009) and thought that they are facing more challenges (0.007). Men believed they had less time to spend with family, implying that women sacrifice working time/income to satisfy family obligations and expectations. Work-life balance is achieved by limiting work hours and including family members. CONCLUSION Women ophthalmologists in Iraq might be facing greater obstacles to their professional advancement than their male counterparts. Female doctors were working fewer hours and doing fewer surgical procedures, and they were less likely to pursue subspecialty certification.
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Affiliation(s)
- Suzan A. Rattan
- Department of Surgery, Al-Kindy College of Medicine/University of Baghdad, Baghdad, Iraq
| | - Mahir K. Mutashar
- Kerato-Refractive Unit, Eye Specialist, Private Hospital, Baghdad, Iraq
| | | | - Zaid Al-Attar
- HLA Unit Al-Kindy College of Medicine/University of Baghdad, Baghdad, Iraq
- Address for correspondence: Dr. Zaid Al-Attar, Al-Kindy College of Medicine/University of Baghdad, Iraq. E-mail:
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Gedde SJ, Feuer WJ, Crane AM, Shi W. Factors Influencing Career Decisions and Satisfaction Among Newly Practicing Ophthalmologists. Am J Ophthalmol 2022; 234:285-326. [PMID: 34157277 DOI: 10.1016/j.ajo.2021.06.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 04/12/2021] [Accepted: 06/12/2021] [Indexed: 11/01/2022]
Abstract
PURPOSE To describe the career choices of newly practicing ophthalmologists and explore factors influencing career decisions and satisfaction. METHODS A cross-sectional study was conducted using data from an electronic survey of ophthalmologists who completed training within the prior 5 years. The survey included questions about demographic information, medical education, current practice, factors affecting career choices, and career satisfaction. Statistical comparisons were made based on gender, type of practice, subspecialty training, and practice area. RESULTS Surveys were completed by 696 (32%) newly practicing ophthalmologists, including 276 (40%) women, 179 (29%) academicians, and 465 (67%) subspecialists. A higher proportion of female respondents entered academics than male respondents (36% vs 26%, P = .009). Female and male respondents pursued fellowship training with similar frequency (64% vs 68%, P = .32), but men were more likely to seek vitreoretinal fellowships (30% vs 11%, P < .001) and women were more likely to undertake fellowships in pediatric ophthalmology (21% vs 8%, P < .001), uveitis (10% vs 2%, P = .002), and neuro-ophthalmology (6% vs 2%, P = .042). A total of 514 (83%) respondents reported being happy with work life. CONCLUSIONS The career choices of newly practicing ophthalmologists differ based on gender, type of practice, subspecialty training, and practice area. Many factors affect career decisions, and they have varying influence on subgroups within ophthalmology. Ophthalmologists have high levels of career satisfaction. This information may prove useful when developing workforce strategies to meet future eye care needs. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.
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Gill HK, Niederer RL, Danesh-Meyer HV. Gender differences in surgical case volume among ophthalmology trainees. Clin Exp Ophthalmol 2021; 49:664-671. [PMID: 34218497 DOI: 10.1111/ceo.13969] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/27/2021] [Accepted: 07/01/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND The number of females in ophthalmology has steadily increased over recent decades. The aim of this study was to evaluate whether there is a difference in procedural volume and cataract surgery between male and female trainees in the Royal Australian and New Zealand College of Ophthalmologists (RANZCO). METHODS A longitudinal retrospective review of de-identified surgical RANZCO trainee logbook data from 2008 to 2020 was undertaken. Data from 241 trainee logbooks were analysed for: location of training, gender, date of commencement of training, maternity/paternity leave status, number of surgeries observed, assisted, supervised and unsupervised. Surgical cases were grouped as: (1) all surgical cases; (2) complete cataract cases and (3) partial cataract cases. RESULTS Among 241 trainees (40.7% females), 197 263 procedures were performed. Total surgical volume was 21.1% lower at 4 years for females (median 665.5 vs. 843.5; p = 0.036). Completed cataract surgery was 21.5% lower at 18 months (median 87.5 vs. 111.5; p = 0.022) and 41.7% lower at 4 years (median 216 vs. 369; p < 0.001). Interrupted training was significantly more common in females (30.6% vs. 0.7%; p < 0.001). However, linear regression analysis did not identify parental leave or duration as a significant predictor for number of completed cataracts (p = 0.206). Complication rate was not different between males and females (p = 0.35). CONCLUSIONS Female trainees completed 41.7% fewer cataract operations at the end of their training compared to male counterparts with the gap widening between years 1 and 4 of training. The current data demonstrates that female and male RANZCO trainees are not receiving equivalent operating experiences.
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Affiliation(s)
- Hannah K Gill
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Rachael L Niederer
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
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Pradeep T, Melachuri S, Arun S, Ravipati A, Wang S, Zhang M, Errera MH, Fu R. Trends in Anti-VEGF Injection Medicare Part B Claims among Male and Female Ophthalmologists from 2012-2016. Semin Ophthalmol 2021; 36:628-632. [PMID: 33678125 DOI: 10.1080/08820538.2021.1890797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Compared to male ophthalmologists, female ophthalmologists have significantly reduced salaries, fewer faculty roles and authored publications, garnered less federal research funding, and achieved less editorial advancement. We aimed to use the most recently available Centers for Medicare and Medicaid Services data to characterize trends and differences in anti-VEGF reimbursements coded for by male and female ophthalmologists.Methods: We used Medicare Fee-For Service Provider Utilization and Payment Data: Part B Provider public use files for 2012-2016 to quantify service and reimbursement patterns for anti-VEGF injections between male and female ophthalmologists. Five outcome variables were studied: number of providers, average Medicare payment amount, total payment, number of services, and number of Medicare beneficiaries.Results: Number of services performed per female provider was 71.2% that of a male ophthalmologist in 2012, and this percentage did not change from 2012 to 2016 (95%CI [0.63, 0.804], [0.984, 1.04], respectively). Female providers had 76.1% of beneficiaries as males in 2012, and this percentage stayed constant throughout the years (95%CI [0.69, 0.84] and [0.99, 1.03], respectively). The total payment difference between female and males was $102,175 per provider in 2012, and this gap widened by $18,292 yearly (95% CI [-162599.17, -41760.47], [-33060.35, -3524.38], respectively).Conclusion: While male and female providers saw considerable increases in aflibercept services and payments in the 5-year period, the gap between male and female reimbursements widened significantly. Moving forward, analysis of large-scale Medicare datasets provides a tangible report card on how effective our attitudes and policies are in cultivating equal opportunity.
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Affiliation(s)
- Tejus Pradeep
- Johns Hopkins School of Medicine.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Samyuktha Melachuri
- Department of Ophthalmology, University of Washington, Seattle, WA, USA.,University of Pittsburgh, Pittsburgh, PA, USA
| | - Siddharth Arun
- Johns Hopkins School of Medicine.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Advaitaa Ravipati
- Johns Hopkins School of Medicine.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Serena Wang
- Johns Hopkins School of Medicine.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Matthew Zhang
- Johns Hopkins School of Medicine.,Department of Ophthalmology, University of Washington, Seattle, WA, USA
| | - Marie Helene Errera
- Department of Ophthalmology, University of Washington, Seattle, WA, USA.,University of Pittsburgh, Pittsburgh, PA, USA
| | - Roxana Fu
- Johns Hopkins School of Medicine.,Department of Ophthalmology, University of Washington, Seattle, WA, USA.,University of Pittsburgh, Pittsburgh, PA, USA
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Meyer JA, Troutbeck R, Oliver GF, Gordon LK, Danesh-Meyer HV. Bullying, harassment and sexual discrimination among ophthalmologists in Australia and New Zealand. Clin Exp Ophthalmol 2020; 49:15-24. [PMID: 33249691 DOI: 10.1111/ceo.13886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 10/02/2020] [Accepted: 10/31/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Discrimination, bullying and sexual harassment (DBSH) impact the psychological well-being of doctors and contribute to poor health outcomes. The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) commissioned independent surveys to evaluate DBSH among members/trainees. METHODS Anonymous online surveys by Best Practice Australia were undertaken in 2015 and 2018. Cross-sectional analysis was prevalence of perceived DBSH, rates of reporting, intervention and resolution undertaken. Response rate was 50% (658/1319) in 2015 and 40% (557/1401) in 2018. In both surveys, 29% were female. This is representative of the distribution of the RANZCO members. RESULTS In a 2015 survey, 37.6% of respondents experienced DBSH, with prevalence being the highest for females (62.3%; N = 104 cf males 27.7%; N = 167) and trainees (49.2%; N = 61). In 2018, 49.2% of respondents reported DBSH with rates low for all forms of DBSH (22%-29%). Sexual harassment was reported by 12% and the least discussed or reported. Respondents strategy for taking action included draw on personal support network (25-43%), official complaints to supervisors (16-22%), human resources (2%-10%) and RANZCO (0%-6%). Reasons for not taking action included fear of impact of future career options (54.1%-60.7%), fear of victimization (35.7%-50.4%) and afraid of not being believed (31.9%-52.4%). Satisfactory resolution rates were 6% to 25%. A majority of respondents (77%) were positive about RANZCO initiatives. CONCLUSIONS DBSH is commonly reported by RANZCO members with female ophthalmologists more than two times more likely to experience any one of the four behaviours, three times more likely to experience discrimination and six times for sexual harassment. Fear of compromising personal and career progression contribute to low levels of reporting.
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Affiliation(s)
- Juliette A Meyer
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Robyn Troutbeck
- Department of Ophthalmology, Royal Victorian Eye and Ear Hospital, Melbourne, Australia
| | - Genevieve F Oliver
- Department of Ophthalmology, Canterbury District Health Board, Christchurch, New Zealand
| | - Lynn K Gordon
- Department of Ophthalmology, David Geffen School of Medicine at the University of California at Los Angeles, Los Angeles, California, USA
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Ahmad S, Ramulu P, Akpek E, Deobhakta A, Klawe J. Gender-Specific Trends in Ophthalmologist Medicare Collections. Am J Ophthalmol 2020; 214:32-39. [PMID: 31926887 DOI: 10.1016/j.ajo.2019.12.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE To assess the factors influencing the Medicare collections disparity between male and female ophthalmologists. DESIGN Retrospective cohort study. METHODS The Medicare Provider Utilization and Payment Data from 2012-2015 were combined with the 2015 Physician Compare National Downloadable file and US Census data. Three complementary regression models were generated for number of patients seen, number of services performed per patient, and the amount collected per service. Predictor variables included gender, calendar year, geography, years since medical school graduation, and subspecialty. RESULTS After adjusting for age, geography, and subspecialty, women ophthalmologists collected 42% less as compared to male ophthalmologists, with the median male ophthalmologist out-earning the 75th-percentile female ophthalmologist across almost all age groups, practice categories, and geographic regions. Although women are entering more lucrative subspecialties (cataract and retina) at a higher rate than before, the percentage of women pursuing these subspecialties remains lower than that of men. CONCLUSIONS Compared with men, women ophthalmologists see fewer patients and have lower Medicare collections. The observed gender gap in collections was highly persistent across years in practice, subspecialty, and geographic region. Future studies are warranted to examine whether the observed gender collections gap results from structural inequities, social circumstances, or personal choices.
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Affiliation(s)
- Sumayya Ahmad
- Icahn School of Medicine of Mount Sinai, New York, New York, USA.
| | - Pradeep Ramulu
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Esen Akpek
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Avnish Deobhakta
- Icahn School of Medicine of Mount Sinai, New York, New York, USA
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Buys YM, Canizares M, Felfeli T, Jin Y. Influence of Age, Sex, and Generation on Physician Payments and Clinical Activity in Ontario, Canada: An Age-Period-Cohort Analysis. Am J Ophthalmol 2019; 205:184-196. [PMID: 31004590 DOI: 10.1016/j.ajo.2019.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 03/30/2019] [Accepted: 04/04/2019] [Indexed: 10/27/2022]
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 1992-2013 were used to calculate the 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 were a lower number of visits (and patients for ophthalmologists) in each succeeding recent birth cohort. For all groups and birth cohorts, male physicians had a 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 with older cohorts at the same age despite similar or a slightly lower number 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.
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Lo TCS, Rogers SL, Hall AJ, Lim LL. Differences in practice of ophthalmology by gender in Australia. Clin Exp Ophthalmol 2019; 47:840-846. [DOI: 10.1111/ceo.13523] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 04/01/2019] [Accepted: 04/21/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Tiffany C. S. Lo
- Ophthalmology, The Royal Victorian Eye and Ear Hospital Melbourne Victoria Australia
- The Centre for Eye Research Australia, The University of Melbourne Melbourne Victoria Australia
| | - Sophie L. Rogers
- The Centre for Eye Research Australia, The University of Melbourne Melbourne Victoria Australia
| | - Anthony J. Hall
- Department of OphthalmologyAlfred Health Melbourne Victoria Australia
| | - Lyndell L. Lim
- Ophthalmology, The Royal Victorian Eye and Ear Hospital Melbourne Victoria Australia
- The Centre for Eye Research Australia, The University of Melbourne Melbourne Victoria Australia
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Jain NS, Kersten HM, Watson SL, Danesh‐Meyer HV. Gender differences in Australasian ophthalmologists' experiences of the workplace. Clin Exp Ophthalmol 2019; 47:706-712. [DOI: 10.1111/ceo.13487] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/12/2019] [Accepted: 02/16/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Neeranjali S. Jain
- Prince of Wales Hospital Clinical SchoolUniversity of New South Wales Sydney New South Wales Australia
| | - Hannah M. Kersten
- School of Optometry and Vision ScienceThe University of Auckland Auckland New Zealand
| | - Stephanie L. Watson
- Prince of Wales Hospital Clinical SchoolUniversity of New South Wales Sydney New South Wales Australia
- Save Sight InstituteUniversity of Sydney Sydney New South Wales Australia
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Influence of Age, Sex, and Generation on Physician Payments and Clinical Activity in Ontario, Canada: An Age-Period-Cohort Analysis. Am J Ophthalmol 2019; 197:23-35. [PMID: 30236775 DOI: 10.1016/j.ajo.2018.09.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 11/20/2022]
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.
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Saurabh K, Sarkar K, Roy R, Majumder PD. Personal and practice profile of male and female ophthalmologists in India. Indian J Ophthalmol 2016; 63:482-6. [PMID: 26265636 PMCID: PMC4550978 DOI: 10.4103/0301-4738.162579] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: The aim of this study was to study the practice pattern, personal profile, and work-family balance of male and female ophthalmologists in India. Materials and Methods: This study was conducted through 41 point questionnaire sent to the members of All India Ophthalmological Society dealing with practice profile and personal circumstances of ophthalmologists. Results: Six hundred and twenty-two (8%) responses were obtained out of 7723 invitations sent. A total of 452 were male and 170 were female ophthalmologists. Age group of 30–39 years was most common age of respondents (male 155; 35.3%; female 81; 47.6%). Larger number of male ophthalmologists (157; 34.7%) worked for more than 9 h a day than female ophthalmologists (41; 24.1%) (P = 0.01). Larger number of male ophthalmologists (229; 50.7%) earned more than Rs. 1 lakh/month than female ophthalmologists (55; 32.4%) (P = 0.00001) More female ophthalmologists (21; 12.4%) than males (26; 5.8%) said that they faced cultural, ethnic or gender bias at work place (P = 0.002). Forty-four (25.9%) female and 54 (12%) male ophthalmologists said that they often curtailed their work for family needs (P = 0.0001). Two hundred and fifty-two (55.8%) male ophthalmologists and 78 (45.9%) female ophthalmologists considered their profession rewarding (P = 0.02). Conclusion: Ophthalmology as a profession was considered rewarding by both male and female ophthalmologists. However, female ophthalmologists were curtailing their work for family needs and earning less than male ophthalmologists. Female ophthalmologists were also subject to gender bias at workplace. These issues need to be tackled to improve the work satisfaction of ophthalmology workforce.
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Affiliation(s)
- Kumar Saurabh
- Vitreoretina Services, Aditya Birla Sankara Nethralaya, Kolkata, West Bengal, India
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Trends in Authorship of Articles in Major Ophthalmology Journals by Gender, 2002–2014. Ophthalmology 2016; 123:1824-1828. [DOI: 10.1016/j.ophtha.2016.04.034] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/16/2016] [Accepted: 04/18/2016] [Indexed: 11/21/2022] Open
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Hos D, Steven P, Dietrich-Ntoukas T. [The situation of residents in ophthalmology in Germany: Results of an online survey]. Ophthalmologe 2015; 112:498-503. [PMID: 26014052 DOI: 10.1007/s00347-015-0030-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE The main purpose of the present survey was to describe the situation of residents in ophthalmology in Germany, including professional aims and plans for the future. By evaluating the current conditions, potential deficits should be identified which could lead to demand-oriented approaches for improvement. METHODS The online questionnaire was sent out per e-mail to 1100 German residents. The rate of received answers was 30.1 % (334 completed questionnaires). RESULTS Of the participants 68 % were female,32 % were male (mean age 31.8 years), one third of the participants had children, 44.6 % worked at university institutions, 54.4 % at non-university institutions and 45.5 % considered themselves as well-trained. Deficits during residency training were seen in the field of neuro-ophthalmology and ophthalmic surgery. The evaluation of the residency in total revealed an overall average grade of 2.9 ("satisfactory"). Of the physicians 35.5 % reported to be actively involved in research projects and 21.9 % reported pursuing an academic career. Almost 50 % of the participant residents aimed to work in a private practice after residency and 15 % aimed to work at an university hospital. CONCLUSION The present survey revealed representative data because of the acceptable return rate and participating residents from all different educational levels (1st to 5th year). The survey can therefore help to characterize the current situation of residents in ophthalmology in Germany and to develop demand-oriented possibilities for improvement.
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Affiliation(s)
- D Hos
- Zentrum für Augenheilkunde, Universität zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland,
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McAlister C, Jin YP, Braga-Mele R, DesMarchais BF, Buys YM. Comparison of lifestyle and practice patterns between male and female Canadian ophthalmologists. Can J Ophthalmol 2014; 49:287-90. [DOI: 10.1016/j.jcjo.2014.02.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 02/07/2014] [Accepted: 02/10/2014] [Indexed: 10/25/2022]
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Lakkis NA, Osman MH, Musharrafieh UM, Issa GM. Psychological distress and job stressors among Lebanese workers: experience from a private sector. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2012; 67:133-144. [PMID: 22845726 DOI: 10.1080/19338244.2011.598887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
No published data exists on the prevalence of psychological distress (PD) among the Lebanese working population, and its association with job stressors. A cross-sectional study was conducted in 2003 among Lebanese employees in a private administrative company. All employees (n = 200) received an anonymous questionnaire by mail. The General Health Questionnaire (GHQ-28) was used to estimate the prevalence of PD. Multiple regression analyses were performed to evaluate the relationship between GHQ-28 Likert score (0-84) and job stressors and other covariates. The participation rate was 79.3%. PD was identified in 30.0% of the studied population. A significant association was found between PD and lack of moral support, a recent disturbing event, feeling of job insecurity, and inability to be proactive. The results showed a high prevalence of PD in the studied population with significant association with job stressors.
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Affiliation(s)
- Najla A Lakkis
- Department of Family Medicine, Faculty of Medicine, American University of Beirut Medical Center, Lebanon.
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Joyce CM, Schurer S, Scott A, Humphreys J, Kalb G. Australian doctors’ satisfaction with their work: results from the MABEL longitudinal survey of doctors. Med J Aust 2011; 194:30-3. [DOI: 10.5694/j.1326-5377.2011.tb04142.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2009] [Accepted: 09/07/2010] [Indexed: 11/17/2022]
Affiliation(s)
| | - Stefanie Schurer
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, VIC
| | - Anthony Scott
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, VIC
| | | | - Guyonne Kalb
- Melbourne Institute of Applied Economic and Social Research, University of Melbourne, Melbourne, VIC
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Author reply. Ophthalmology 2008. [DOI: 10.1016/j.ophtha.2007.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Deva NC, Danesh-Meyer HV. Gender Differences in Income. Ophthalmology 2008; 115:411; author reply 411-2. [DOI: 10.1016/j.ophtha.2007.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Accepted: 10/04/2007] [Indexed: 11/25/2022] Open
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