Changes in the Practice Patterns and Demographics of Ontario Dermatologists

Background: Changes in the practice patterns and demographics of Canadian dermatologists remain largely unknown and would be helpful in assessing the future practice of dermatology across Canada. Objective: To assess changes in the population of Ontario dermatologists over time and the factors that influence their practice patterns, caseload, and the procedures they perform. Methods: A retrospective population-based analysis was performed using comprehensive administrative data on Ontario Health Insurance Plan insured dermatology visits and procedures from April 1, 2009, to March 31, 2015. Results: The number of dermatologists practicing in Ontario per 100 000 people increased from 1.52 (2009) to 1.62 (2014). During this period, the proportion of female dermatologists increased from 40% to 47%, and the proportion of male dermatologists decreased from 60% to 53%. The mean number of patient visits per dermatologist decreased from 6323 (2009) to 5877 (2014). Females saw a decrease from 4818 to 4181 visits, and males remained constant at 7274 to 7265 visits. Middle career dermatologists had more patient visits compared to those in their early or late career. A rural practice was associated with more patient visits compared to an urban one. The proportion of dermatologists providing nonemergency in-hospital patient services declined. The number of biopsies and malignant excisions performed increased. Conclusions: The number of dermatologists at the population level increased and the number of patient visits per dermatologist decreased. Career stage, physician sex, and practice location all affect the practice of dermatology. Future studies to assess underlying factors for these observations would be of value.