PEDIATRICS Vol. 85 No. 2 February 1990, pp. 144-149
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Age- and Gender-Related Differences in Clinical Productivity Among Canadian Pediatricians

Michael J. Rieder MD FRCPC1, Sandra J. Hanmer MHSC, CHE1, and Robert H. A. Haslam MD, FRCPC1

1 From the Departments of Paediatrics and Pharmacology, Children's Hospital of Western Ontario, University of Western Ontario, London, Ontario, and the Department of Paediatrics, Hospital for Sick Children, Toronto, Ontario, Canada

The desire to control health care costs in Canada has led to reductions in postgraduate training posts and physician immigration. To determine the possible effects of these cutbacks on pediatric manpower, a country-wide study was conducted to assess the practice patterns and productivity of Canadian pediatricians. Of the 1960 pediatricians in Canada, 69% completed and returned our questionnaire. Practice descriptions were as follows: 37% practice primary, 25% secondary, and 38% tertiary care. A total of 70% of Canadian pediatricians are men, although this will change with time because 49% of pediatricians younger than 35 years of age are women. Clinical productivity was assessed by five indices: number of clinical hours, patients seen, consultations provided, and hours on call per week, and number of hospital admissions per year. Younger pediatricians were significantly less clinically productive than older pediatricians. Age-matched groups of female pediatricians were significantly less clinically productive than their male counterparts in three of the five indices assessed. Overall, female pediatricians were significantly more likely to work part-time than were male pediatricians (22% vs 16%, P < .05). When the clinical productivity of parttime pediatricians was assessed, there was no male to female difference noted. However, among full-time pediatricians, men worked significantly more clinical hours per week and saw significantly more patients than did women (P < .05). According to results, women pediatricians were more satisfied with their practice now than when starting practice than were men (47% vs 41%). A dramatic decline has been projected in the number of tertiary care pediatricians in the province of Ontario during the next two decades as a result of government cutbacks in pediatric trainees and reduced physician immigration. When coupled to a slightly lesser clinical productivity, a sharp decline in accessibility of subspecialty care for Canadian children in the future is likely to occur.

Key Words: clinicalproductivity • Canadian pediatricians

Submitted on January 26, 1989
Accepted on April 6, 1989




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