Measuring the Rheumatologist Workforce in Canada: Preliminary Results of the Stand up and be Counted Survey

Claire E H Barber¹, Lauren Jewett², Vandana Ahluwalia³, Cory Baillie^4,5, Dianne Mosher⁶, Michel Zummer⁷, J Carter Thorne⁸, Janet Ellsworth⁹, Henry Averns¹⁰, Cheryl Barnabe¹¹, Alfred Cividino¹², Janet E. Pope¹³, Elizabeth M. Badley^14,15, Deborah M. Levy¹⁶, Thanu Ruban¹⁴, Katie Lundon¹⁷, Robert McDougall¹⁸, Julie Brophy¹, Diane Lacaille¹⁹, Deborah Marshall² and The Canadian Rheumatology Association (CRA) Human Resources Committee, ¹Rheumatology, University of Calgary, Calgary, AB, Canada, ²University of Calgary, Calgary, AB, Canada, ³William Osler Health Center, Brampton, ON, Canada, ⁴Canadian Rheumatology Association (President), Winnipeg, MB, Canada, ⁵University of Manitoba, Winnipeg, MB, Canada, ⁶Med, University of Calgary, Calgary, AB, Canada, ⁷Université de Montréal, Quebec, QC, Canada, ⁸Southlake Regional Health Centre, Newmarket, ON, Canada, ⁹University of Alberta, Edmonton, AB, Canada, ¹⁰Consultant Rheumatologist Kingston Ontario, Kingston, ON, Canada, ¹¹Cumming School of Medicine, University of Calgary, Calgary, AB, Canada, ¹²Department of Medicine, McMaster University, Hamilton, AB, Canada, ¹³University of Western Ontario, London, ON, Canada, ¹⁴University of Toronto, Toronto, ON, Canada, ¹⁵Toronto Western Research Institute, Toronto, ON, Canada, ¹⁶Rheumatology, The Hospital for Sick Children, Toronto, ON, Canada, ¹⁷Medicine, University of Toronto, Toronto, ON, Canada, ¹⁸University of Saskatchewan, Regina, SK, Canada, ¹⁹Arthritis Research Centre, University of British Columbia, Vancouver, BC, Canada

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Rheumatology and Workforce

Session Information

Date: Monday, November 9, 2015

Title: Health Services Research Poster II (ACR): Healthcare Access, Patterns of Medication Use and Workforce Considerations

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Given the rising burden of arthritis care, there is concern about access to rheumatologists in many regions. To better characterize the rheumatologist workforce, the Canadian Rheumatology Association (CRA) launched the Stand Up and Be Counted survey in March 2015.

Methods: Following a literature review of existing workforce studies to identify gaps in knowledge, a working group including the research team, CRA staff and adult and pediatric rheumatologists from academic and community practices developed and pilot-tested English and French versions of the survey. The survey consisted of 63 questions including demographic and practice information, questions on provision of care to rural and remote communities, and allocation of time for clinical care. The survey was distributed to the CRA membership, with non-CRA members identified through the Royal College of Physicians and Surgeons, provincial licensing bodies, and snowball recruitment from other CRA members. To increase survey uptake, periodic electronic reminders were sent out to non-respondents and study updates were provided at regional meetings.

Results: The survey was sent to 657 individuals of whom 456 were expected to be practicing rheumatologists (400 adult, 56 pediatric) based on CRA membership information. As of May 2015 there were 320 respondents (49%), of which 33 were excluded, as they were not actively practicing rheumatologists or did not complete enough of the survey to determine this. There were 287 respondents included in this preliminary analysis, including 244 adult rheumatologists, and 43 pediatric rheumatologists, representing 61% and 76% of the expected respondents respectively. The median age was 50 years and nearly a third (90, 31%) plan to retire within the next 10 years. Sixty percent were affiliated with a university: 136 had a university-based clinic and an additional 37 had an academic appointment but practiced in a private community-based setting. Of the remaining respondents, 103 had community-based clinics and 11 reported other types of practice settings. Thirty-one percent of rheumatologists did not use an electronic medical record. With respect to rheumatologists’ clinical practices and workload: the majority of the respondents’ caseloads were comprised of patients with inflammatory arthritis (70%) and the median number of ½ day clinics offered per week was 8. The majority of rheumatologists’ time was devoted to clinical practice (70%) while the remainder was spent on research, teaching or administration activities (10% each). Two-thirds participate in a call roster within their centers. To provide care to rural and remote communities 48 rheumatologists offer travelling clinics (16%), and 42 participate in Telehealth or eConsultations (15%).

Conclusion: The Stand Up and Be Counted survey is the first CRA national rheumatology workforce survey in Canada. The results highlight an ongoing need for training rheumatologists given that 1/3 of the workforce will be retiring in the next 10 years. Adoption of alternative models of care may be an option to increase clinical capacity, and enhanced use of technology to deliver care to remote and rural populations should be considered.

Disclosure: C. E. H. Barber, None; L. Jewett, None; V. Ahluwalia, None; C. Baillie, None; D. Mosher, None; M. Zummer, Janssen Inc, 5; J. C. Thorne, None; J. Ellsworth, None; H. Averns, None; C. Barnabe, Roche, Amgen, Abbott, 5; A. Cividino, Pfizer Inc, Celgene, Roche, BMS, 2,Pfizer Inc, Celgene, Roche, BMS, 8; J. E. Pope, None; E. M. Badley, None; D. M. Levy, None; T. Ruban, None; K. Lundon, None; R. McDougall, None; J. Brophy, None; D. Lacaille, None; D. Marshall, None.

To cite this abstract in AMA style:

Barber CEH, Jewett L, Ahluwalia V, Baillie C, Mosher D, Zummer M, Thorne JC, Ellsworth J, Averns H, Barnabe C, Cividino A, Pope JE, Badley EM, Levy DM, Ruban T, Lundon K, McDougall R, Brophy J, Lacaille D, Marshall D. Measuring the Rheumatologist Workforce in Canada: Preliminary Results of the Stand up and be Counted Survey [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/measuring-the-rheumatologist-workforce-in-canada-preliminary-results-of-the-stand-up-and-be-counted-survey/. Accessed .

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