Purpose: To investigate the reasons underlying gender-based differences in patient volume, we aimed to determine whether female physicians spend more face-to-face time with patients than their male counterparts. Prior studies have suggested that female ophthalmologists bill significantly less, yet work a similar number of hours per week. Studies within family medicine indicate that patient visits are on average 10% longer with female family physicians than male physicians. No studies have yet investigated the influence of gender on patient encounter length in ophthalmology.

Study Design:  Cross-sectional study

Methods: This study was approved by the Western University institutional review board. A total of 22 ophthalmologists in Ontario, 10 female and 12 male, were recruited. Subspecialists were included, provided there was at least one matched subspecialist of the opposite gender who also participated. An independent observer gathered data by timing approximately 100 patient encounters for each participating physician. Data collected included the face-to-face time spent with the patient, physician gender, patient gender and type of visit (e.g. consult, follow-up). Statistical analysis using t-test was performed using GraphPad Prism 8. 

Results: A total of 2009 patient encounters were observed, 513 new consults and 1496 follow up visits. The average time spent with patients was significantly longer for female ophthalmologists (8.0 minutes +/- 4.3) than for male ophthalmologists (7.2 minutes +/- 4.2, p<0.0001). Male and female ophthalmologists spent approximately the same time seeing patients in consultation (9.2 minutes +/- 4.4 vs. 9.4 minutes +/- 5.1; p = 0.572) but male physicians were significantly faster at seeing follow ups (6.6 minutes +/- 3.5) compared to female physicians (7.8 minutes +/- 3.9, p < 0.0001). Appointment times did not significantly differ between male patients and female patients (7.4 minutes +/- 4.2 vs. 7.4 minutes +/- 4.3; p = 0.9583). 

Conclusions: Female ophthalmologists spend significantly more time with each patient encounter compared to their male counterparts when seeing patients in follow up, but not in consultation. Considering the greater number of follow up versus consultation visits, this is likely an important driver of the reduced patient volume seen by female ophthalmologists.

Duration of patient encounters in ophthalmology clinics based on physician and patient gender

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