Evidence map›Paper›PMID 38670580›Full record

ArticleCanadian journal of surgery. Journal canadien de chirurgie

Orthopedic surgeons' transition into full-time practice over the last 20 years: an analysis using Ministry of Health billing data.

Silvio Ndoja, Amirti Vivekanandan, Sophia Frost, Emil Schemitsch, Lyn M Sibley, Steve Papp, Brent Lanting

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Silvio NdojaFrom the Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Ndoja, Vivekanandan, Frost, Schemitsch, Lanting); London Health Sciences Centre, London, Ont. (Ndoja, Vivekanandan, Schemitsch, Lanting); the Ontario Medical Association, Toronto, Ont. (Sibley); the Division of Orthopedic Surgery, University of Ottawa, Ottawa, Ont. (Papp); the Ottawa Hospital, Ottawa, Ont. (Papp) silviondoja@gmail.com.
Amirti VivekanandanFrom the Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Ndoja, Vivekanandan, Frost, Schemitsch, Lanting); London Health Sciences Centre, London, Ont. (Ndoja, Vivekanandan, Schemitsch, Lanting); the Ontario Medical Association, Toronto, Ont. (Sibley); the Division of Orthopedic Surgery, University of Ottawa, Ottawa, Ont. (Papp); the Ottawa Hospital, Ottawa, Ont. (Papp).
Sophia FrostFrom the Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Ndoja, Vivekanandan, Frost, Schemitsch, Lanting); London Health Sciences Centre, London, Ont. (Ndoja, Vivekanandan, Schemitsch, Lanting); the Ontario Medical Association, Toronto, Ont. (Sibley); the Division of Orthopedic Surgery, University of Ottawa, Ottawa, Ont. (Papp); the Ottawa Hospital, Ottawa, Ont. (Papp).
Emil SchemitschFrom the Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Ndoja, Vivekanandan, Frost, Schemitsch, Lanting); London Health Sciences Centre, London, Ont. (Ndoja, Vivekanandan, Schemitsch, Lanting); the Ontario Medical Association, Toronto, Ont. (Sibley); the Division of Orthopedic Surgery, University of Ottawa, Ottawa, Ont. (Papp); the Ottawa Hospital, Ottawa, Ont. (Papp).
Lyn M SibleyFrom the Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Ndoja, Vivekanandan, Frost, Schemitsch, Lanting); London Health Sciences Centre, London, Ont. (Ndoja, Vivekanandan, Schemitsch, Lanting); the Ontario Medical Association, Toronto, Ont. (Sibley); the Division of Orthopedic Surgery, University of Ottawa, Ottawa, Ont. (Papp); the Ottawa Hospital, Ottawa, Ont. (Papp).
Steve PappFrom the Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Ndoja, Vivekanandan, Frost, Schemitsch, Lanting); London Health Sciences Centre, London, Ont. (Ndoja, Vivekanandan, Schemitsch, Lanting); the Ontario Medical Association, Toronto, Ont. (Sibley); the Division of Orthopedic Surgery, University of Ottawa, Ottawa, Ont. (Papp); the Ottawa Hospital, Ottawa, Ont. (Papp).
Brent LantingFrom the Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ont. (Ndoja, Vivekanandan, Frost, Schemitsch, Lanting); London Health Sciences Centre, London, Ont. (Ndoja, Vivekanandan, Schemitsch, Lanting); the Ontario Medical Association, Toronto, Ont. (Sibley); the Division of Orthopedic Surgery, University of Ottawa, Ottawa, Ont. (Papp); the Ottawa Hospital, Ottawa, Ont. (Papp).

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUnderemployment is a reality for many new graduates, who accept locum or part-time work as an alternative to unemployment because of lack of opportunities. We sought to analyze orthopedic surgeons' Ontario Health Insurance Program (OHIP) billing data over a 20-year period as a proxy of practice patterns and hypothesized that billing in the first 6 years of practice would be affected by underemployment and locum.

methodsWe analyzed the annual average billing totals of orthopedic surgeons, broken down by year of graduation, year of billings, and number of surgeons billing in that year. We analyzed public census data of the Ontario population size as a proxy of orthopedic demand.

resultsA 2019 cross-sectional analysis showed that around 15 surgeons per graduating year were billing in Ontario from the 1995 to 2016 cohorts, while 2017 and 2018 saw an increase to 30 and 36 actively billing surgeons, respectively. The number returned to more historical numbers in 2019, with 20 actively billing surgeons. For those surgeons billing in Ontario, billing trends have been roughly stable, with average billings increasing each year for the first 6 years in practice (

conclusionThe Ontario health care system has not expanded to support more orthopedic surgeons despite the aging and growing population; despite our growing population, the number of surgeons being trained and retained has not matched this growth. Further research needs to be done to guide optimal health human resource decision-making.

Indexed as

Orthopedic SurgeonsCross-Sectional StudiesHumansOntarioOrthopedicsPractice Patterns, Physicians'

Identifiers

PMID38670580
PMCPMC11052579

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.