The private practice of rheumatology. The first 1,000 patients

Although this report of the first 1,000 patients in a rheumatologic consultative private practice cannot necessarily reflect the general experience of rheumatology, certain conclusions may be valid and may help to guide the rheumatologist-in-training. Approximately 70% of our patients were categorized as having "inflammatory" or "connective tissue' disorders, rather than degenerative disorders. Internists and general practitioners were the principal referral sources. Over 80% of referrals came from a relatively small geographic radius of 10-15 miles. A population base of perhaps 200,000 people, therefore, may be necessary to support a purely rheumatologic practice. A relatively steady flow of 2 new patients per day was not significantly influenced by subsequent additional rheumatologists moving into the area. However, the pattern of referrals clearly changed to include more patient-to-patient referrals (nearly 30%), perhaps reflecting both loss of physician referral sources and the increasing number of referrals from satisfied patients over a period of time.