Research ArticleArticle
Open Access
Feminization of the Rheumatology Workforce: A Longitudinal Evaluation of Patient Volumes, Practice Sizes, and Physician Remuneration
Jessica Widdifield, Jodi M. Gatley, Janet E. Pope, Claire E.H. Barber, Bindee Kuriya, Lihi Eder, Carter Thorne, Vicki Ling, J. Michael Paterson, Vandana Ahluwalia, Courtney Marks and Sasha Bernatsky
The Journal of Rheumatology December 2020, jrheum.201166; DOI: https://doi.org/10.3899/jrheum.201166
Jessica Widdifield
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Jodi M. Gatley
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Janet E. Pope
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Claire E.H. Barber
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Bindee Kuriya
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Lihi Eder
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Carter Thorne
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Vicki Ling
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
J. Michael Paterson
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Vandana Ahluwalia
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Courtney Marks
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Sasha Bernatsky
This study was funded by an operating grant from the Canadian Initiative for Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer review of the study proposal. This study was supported by ICES, which is funded by an annual grant from the Ontario Ministry of Health and Long-Term Care (MOHLTC). Parts of this material are based on data and information compiled and provided by the MOHLTC. The analyses, conclusions, opinions, and statements expressed herein are solely those of the authors and do not reflect those of the funding or data sources; no endorsement is intended or should be inferred. JW receives support from the Arthritis Society Stars Career Development Award (STAR-19-0610). CEB receives support from the Arthritis Society Stars Career Development Award funded by the Canadian Institutes of Health Research-Institute of Musculoskeletal Health and Arthritis STAR-19-0611/ CIHR SI2-169745. SB holds a career award from the Fonds de la recherche en santé du Québec. 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. E. Pope, MD, MPH, Division of Rheumatology, Western University, Schulich School of Medicine & Dentistry, and St Joseph’s Health Care, London, Ontario; C.E. Barber, MD, PhD, The Cumming School of Medicine, University of Calgary, Calgary, Alberta, and Arthritis Research Canada; B. Kuriya, MD, SM, Division of Rheumatology, University of Toronto, and Sinai Health System, Toronto, Ontario; L. Eder, MD, PhD, Women’s College Research Institute, and University of Toronto, Toronto, Ontario; C. Thorne, MD, Department of Medicine, University of Toronto, Toronto, and Southlake Regional Health Centre, Newmarket, Ontario; J.M. Paterson, MSc, ICES, Toronto, and McMaster University, Department of Family Medicine, Hamilton, and Institute of Health Policy, Management & Evaluation, University of Toronto, Toronto, Ontario; V. Ahluwalia, MD, William Osler Health System, Brampton, Ontario; C. Marks, Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario; 11S. Bernatsky, MD, PhD, Department of Epidemiology, McGill University, and Research Institute of the McGill University Health Centre, Montreal, Québec, Canada. The authors declare no conflicts of interest. Address correspondence to Dr. J. Widdifield, Holland Bone & Joint Research Program, Sunnybrook Research Institute, MG 352-2075 Bayview Avenue, Toronto, ON M4N 3M5, Canada. Email: jessica.widdifield@utoronto.ca. Full Release Article. For details see Reprints and Permissions at jrheum.org. Accepted for publication November 19, 2020.
Abstract
Objective 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.
Methods 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.
Results 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.
Conclusion 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.
In this issue
The Journal of Rheumatology
Vol. 48, Issue 4
1 Apr 2021
Feminization of the Rheumatology Workforce: A Longitudinal Evaluation of Patient Volumes, Practice Sizes, and Physician Remuneration
Jessica Widdifield, Jodi M. Gatley, Janet E. Pope, Claire E.H. Barber, Bindee Kuriya, Lihi Eder, Carter Thorne, Vicki Ling, J. Michael Paterson, Vandana Ahluwalia, Courtney Marks, Sasha Bernatsky
The Journal of Rheumatology Dec 2020, jrheum.201166; DOI: 10.3899/jrheum.201166
Feminization of the Rheumatology Workforce: A Longitudinal Evaluation of Patient Volumes, Practice Sizes, and Physician Remuneration
Jessica Widdifield, Jodi M. Gatley, Janet E. Pope, Claire E.H. Barber, Bindee Kuriya, Lihi Eder, Carter Thorne, Vicki Ling, J. Michael Paterson, Vandana Ahluwalia, Courtney Marks, Sasha Bernatsky
The Journal of Rheumatology Dec 2020, jrheum.201166; DOI: 10.3899/jrheum.201166
