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Stand Up and Be Counted: Measuring and Mapping the Rheumatology Workforce in Canada
Claire E H Barber1,2, Lauren Jewett3,4, Elizabeth M Badley3,4
1From the Division of Rheumatology, Department of Medicine, University of Calgary, Cumming School of Medicine, McCaig Institute for Bone and Joint Health; Department of Geography, and Department of Community Health Sciences, University of Calgary, Calgary; Division of Pediatric Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; Division of Rheumatology, Department of Medicine, University of Alberta, Edmonton, Alberta; Arthritis Research Canada, Richmond; Division of Rheumatology, Department of Medicine, University of British Columbia, Vancouver, British Columbia; Krembil Research Institute, Toronto Western Hospital; Dalla Lana School of Public Health, University of Toronto; Hospital for Sick Children; Pediatrics, University of Toronto; Faculty of Medicine, University of Toronto, Toronto; Rheumatology, McMaster University, Hamilton; William Osler Health System, Brampton; Private Practice, Kingston; Canadian Rheumatology Association; The Arthritis Program at Southlake Regional Health Centre, Newmarket; Division of Rheumatology, University of Western Ontario, London; Department of Medicine, Division of Rheumatology, University of Ottawa, Ottawa; Private Practice, Guelph; Private Practice, Markham, Ontario; University of Manitoba, Winnipeg, Manitoba; Rheumatology, Hôpital Maisonneuve-Rosemont; Université de Montréal, Montreal, Quebec; University of Saskatchewan, Regina, Saskatchewan, Canada. cehbarbe@ucalgary.ca.
Objective:
To characterize the practicing rheumatologist workforce, the Canadian Rheumatology Association (CRA) launched the Stand Up and Be Counted workforce survey in 2015.
Methods:
The survey was distributed electronically to 695 individuals, of whom 519 were expected to be practicing rheumatologists. Demographic and practice information were elicited. We estimated the number of full-time equivalent rheumatologists per 75,000 population from the median proportion of time devoted to clinical practice multiplied by provincial rheumatologist numbers from the Canadian Medical Association.
Results:
The response rate was 68% (355/519) of expected practicing rheumatologists (304 were in adult practice, and 51 pediatric). The median age was 50 years, and one-third planned to retire within the next 5-10 years. The majority (81%) were university-affiliated. Rheumatologists spent a median of 70% of their time in clinical practice, holding 6 half-day clinics weekly, with 10 new consultations and 45 followups seen per week. Work characteristics varied by type of rheumatologist (adult or pediatric) and by practice setting (community- or university-based). We estimated between 0 and 0.8 full-time rheumatologists per 75,000 population in each province. This represents a deficit of 1 to 77 full-time rheumatologists per province/territory to meet the CRA recommendation of 1 rheumatologist per 75,000 population, depending on the province/territory.
Conclusion:
Our results highlight a current shortage of rheumatologists in Canada that may worsen in the next 10 years because one-third of the workforce plans to retire. Efforts to encourage trainees to enter rheumatology and strategies to support retention are critical to address the shortage.
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