Background/Purpose: A rheumatology workforce survey conducted in Canada in 2015 predicted a looming critical shortage of rheumatologists, with one third of surveyed rheumatologists indicating plans to retire between 2020-2025¹. Moreover, the demographics of the available workforce are changing as females and millennials now comprise a larger proportion of practicing rheumatologists. The Canadian Rheumatology Association (CRA) distributed the 2020 Workforce and Wellness Survey to update the Canadian rheumatology workforce characteristics. As the survey was launched during the COVID-19 pandemic, it provided the opportunity to understand the impact of the pandemic on rheumatologists’ practices and burnout.

Methods: The survey was developed from the 2015 iteration and expanded to include the additional aims. It consisted of 26 questions including demographic and practice information, how the pandemic impacted practice, and the Mini-Z questionnaire² was used to assess burnout. After pilot testing by 8 rheumatologists, French and English versions of the electronic survey were distributed to CRA members with 12 email reminders. The survey was open for responses from 10/14/2020-03/05/2021. We estimated the number of full-time equivalent (FTE) rheumatologists per 75,000 population from the median proportion of time in clinical practice multiplied by provincial rheumatologist numbers from the Canadian Medical Association.

Results: The response rate was 43% (183/430) of expected practicing rheumatologists (149 adult and 34 pediatric). The median age was 47 years, 62% were female, and 28% planned to retire within the next 5-10 years. Rheumatologists spent a median of 70% of their time in clinical practice, holding a median of 6 (IQR 3-7) half-day clinics, with 6 (IQR 4-12) new consultations and 40 (IQR 25-60) follow-ups seen per week. We estimated between 0 and 0.70 FTE rheumatologists per 75,000 population in each province/territory and 0.62 per 75,000 population in Canada. This represents a deficit of 1 to 78 FTE rheumatologists per province/territory and a total of 194 FTE rheumatologists needed in Canada to meet the CRA recommendation of 1 rheumatologist per 75,000 population.

As a result of the pandemic, rheumatologists were more engaged in virtual care (97% increase). There was a reported reduction in the number of half-day clinics per week, with fewer new and follow-up patients seen per week, and more time spent on clinical paperwork.

Over half of rheumatologists (51%) reported burnout. Women were at 2.86 (95%CI 1.42, 5.93) increased odds of burnout. Age was protective against burnout, with a decrease in odds of 0.95% (95%CI 0.92, 0.99) per year of age.

Conclusion: We highlight the ongoing shortage of rheumatologists in Canada and that this is likely to worsen in the near future without increasing new graduates to cover retirements. This problem may be compounded by the threat of burnout to the retention and productivity of the current workforce. The pandemic has significantly impacted patient volume, likely affecting rheumatologist remuneration and contributing to delayed care.

1. Barber et al; J Rheumatol 2017;44(2):248-57.
2. Olson et al; Stress Health 2019;35(2):157-75.

« Back to ACR Convergence 2021

ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-rheumatology-workforce-in-canada-results-of-the-workforce-and-wellness-survey/