Exclusive cataract surgical focus among ophthalmologists: a population-based analysis

Area of Science:

• Ophthalmology
• Surgical Practice Trends
• Health Workforce Analysis

Background:

• Surgical subspecialization may lead to a narrower scope of practice for comprehensive ophthalmologists.
• Understanding trends in surgical focus is crucial for healthcare planning.

Purpose of the Study:

• To investigate the trend of narrowing surgical practice among ophthalmologists.
• To determine the proportion of ophthalmologists exclusively providing cataract surgery over time.

Main Methods:

• Retrospective, population-based study using linked healthcare databases in Ontario (1994-2016).
• Evaluated the proportion of ophthalmologists exclusively performing cataract surgery versus other procedures.
• Assessed surgical case distribution within individual ophthalmologists' practices.

Main Results:

• The percentage of ophthalmologists exclusively performing cataract surgery increased from 10.0% to 34.9% (p < 0.0001) between 1994 and 2016.
• Proportions of ophthalmologists in other surgical subspecialties remained stable.
• Exclusive cataract surgeons demonstrated high focus, with median annual case volumes increasing significantly by 2009.

Conclusions:

• Exclusive cataract surgical focus among Ontario ophthalmologists rose dramatically, from 1 in 10 to 1 in 3 surgeons, between 1994 and 2016.
• This trend was consistent across both new graduates and experienced ophthalmologists.
• Findings have implications for surgeon workforce policies and training program development.