Work-load of optalmologists in France

Aims: In order to predict the number of ophthalmologists which need to be trained in France between 2000 and 2020, we studied the number of office visits, diagnostic procedures and therapeutic procedures private-practice ophthalmologists performed per year. Method: We performed a descriptive and multivariate analysis using principal components and a hierarchic classification. Results: Men had a greater work-load than women. Physicians who accepted the National Fee Schedule as payment in full performed more office visits and diagnostic procedures but fewer surgical procedures than physicians who did not. Physicians who were trained before the medical-studies reform in 1985 performed less surgery than those who received their training after 1985. A principal component analysis identified four classes of physicians. Class 1 physicians (35.6% of all ophthalmologists) performed a high number of office visits, somewhat fewer diagnostic procedures and many fewer surgical procedures than the national average. Class 2 physicians (48.6% of all ophthalmologists) performed many office visits, although their average work-load was only 40% the work-load of class 1 physicians. They performed few diagnostic and surgical procedures. Class 3 physicians (5.1% of all ophthalmologists) performed a much higher than average number of diagnostic procedures, a nearly average number of surgical procedures and approximately the same number of office visits as class 2 physicians. Finally, Class 4 physicians (10.7% of all ophthalmologists) exclusively performed diagnostic and surgical procedures. Conclusion: The wide variation in the work-loads of private-practice ophthalmologists has to be considered when determining future needs based on the existing resources.