Trends in changing practice demographics, issues mirrored in AAO survey

Among the trends from a membership survey conducted by the American Academy of Ophthalmology are an increase in part-time practice and greater diversity. However, many share similar concerns about upheavals in health care.

Take-home message: Among the trends from a membership survey conducted by the American Academy of Ophthalmology are an increase in part-time practice and greater diversity. However, many share similar concerns about upheavals in health care.


By Nancy Groves; Reviewed by Tamara R. Fountain, MD


Chicago-A snapshot of today’s ophthalmologists would capture a more diverse group than several years earlier, greater interest in part-time practice, and general satisfaction with their career choice.

Responses to the most recent American Academy of Ophthalmology (AAO) biennial membership survey, conducted in 2013, also reveal several generational differences, said Tamara R. Fountain, MD.

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“A lot of things were the same, but a lot of things are changing, and one area in particular was part-time positions,” said Dr. Fountain, membership secretary, AAO, and professor of ophthalmology, Rush University Medical Center, Chicago.

The survey was mailed to 3,000 members; about 900 responded. According to the responses, 22% of AAO members practice part-time.

“That might seem like a small number, but when you look at trends, the number almost doubled between the last time we took the survey in 2011 and 2013,” she said.

The average physician workload is 45 hours per week, whereas part-time physicians-who are more likely to be general ophthalmologists-work about 25 hours per week. They’re also more likely to be either solo practitioners or in small groups of 2 to 5 doctors. Part-time practitioners are keeping busy, however.

If the average ophthalmologist sees 110 patients per week, the average part-time clinician sees 77 patients, Dr. Fountain said.

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“They’re more productive because the part-timer is working about 55% of the time but seeing about 70% of the patients,” she explained. “They’re more likely to see routine patients as opposed to problem-focused patients, and they do about half the number of surgeries. If the average practice has 6 doctors in it, people who work part-time come from slightly smaller practices.

Next: Practice diversity stats


“When I first saw these statistics, my thought was this must represent women coming into ophthalmology and more women wanting work-life balance,” Dr. Fountain continued. “But we see two trends. Not only do we see that more women are likely to be part-timers, but they (the part-time clinicians) are also more likely to be older ophthalmologists who have been in practice longer.”


Diversity in practice

About one in four AAO members are women. This is not surprising since about one-half of all medical school students are women, but the percentage is changing quickly. Just 5 years, ago only 12% of AAO members were women.

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The racial background of the membership is also changing. In the latest survey, about 77% of members were Caucasian and 12%, the second largest segment, described themselves as Asian. Ten years ago, 90% of survey respondents described themselves as Caucasian.

Young ophthalmologists-those in training or in practice less than 5 years-are classified as a subgroup within the survey responses, and their profile is different in several ways from that of their older colleagues.

“We look at these separately because they learn differently, they approach life differently, and they’ve come up in a different system than we did,” Dr. Fountain said. “As you might expect, they’re more likely to be female, they’re more likely to be racially diverse, and they’re more likely to say that they’re planning to be subspecialists and less likely to be solo practitioners.”

Next: Satisfaction rates


Regardless of age, most ophthalmologists face similar issues. In response to a survey question about what keeps them awake at night, physicians’ chief concerns were changes in physician payment, changes in the general regulatory environment, and health-care reform.

Pleased with career choice

“Despite all the changes and the upheavals in health care at this time, across all the demographics that we surveyed, satisfaction rates with their career choice continue to be high,” Dr. Fountain said.

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About 90% of physicians overall reported they were satisfied. However, just 63% of U.S. members and fellows were extremely or very satisfied with their practice situation, as were 70% of international members and fellows. Only 14% of U.S. members would not recommend ophthalmology as a career, compared with 4% of international members.

Members in training were a bit more optimistic. Seventy-six percent of those in the United States and 89% of international members would endorse an ophthalmology career path.

“Sometimes we’re less likely to recommend it as a career. We’re worried about the future and perhaps we’re worried about our kids going into medicine. But at least at this time, we’re happy with our career choice, and it shows,” Dr. Fountain said. “Some things are changing, but there are a lot of things that won’t change.”



Tamara R. Fountain, MD

P: 847/945-6770


This article was adapted from Dr. Fountain’s presentation during the 2014 meeting of the American Academy of Ophthalmology. Dr. Fountain is a consultant for Ophthalmic Mutual Insurance Co.