Stand Up and Be Counted: Measuring and Mapping the Rheumatology Workforce in Canada

Claire E H Barber; Lauren Jewett; Elizabeth M Badley; Diane Lacaille; Alfred Cividino; Vandana Ahluwalia; Henry Averns; Cory Baillie; Janet Ellsworth; Janet Pope; Deborah Levy; Christine Charnock; Claire McGowan; J Carter Thorne; Cheryl Barnabe; Michel Zummer; Katie Lundon; Robert S McDougall; John G Thomson; Elaine A Yacyshyn; Dianne Mosher; Julie Brophy; Thanu Nadarajah Ruban; Deborah A Marshall

doi:10.3899/jrheum.160621

Stand Up and Be Counted: Measuring and Mapping the Rheumatology Workforce in Canada

J Rheumatol. 2017 Feb;44(2):248-257. doi: 10.3899/jrheum.160621. Epub 2016 Dec 1.

Authors

Claire E H Barber^{1

2}, Lauren Jewett^{3

4}, Elizabeth M Badley^{3

4}, Diane Lacaille^{3

4}, Alfred Cividino^{3

4}, Vandana Ahluwalia^{3

4}, Henry Averns^{3

4}, Cory Baillie^{3

4}, Janet Ellsworth^{3

4}, Janet Pope^{3

4}, Deborah Levy^{3

4}, Christine Charnock^{3

4}, Claire McGowan^{3

4}, J Carter Thorne^{3

4}, Cheryl Barnabe^{3

4}, Michel Zummer^{3

4}, Katie Lundon^{3

4}, Robert S McDougall^{3

4}, John G Thomson^{3

4}, Elaine A Yacyshyn^{3

4}, Dianne Mosher^{3

4}, Julie Brophy^{3

4}, Thanu Nadarajah Ruban^{3

4}, Deborah A Marshall^{3

4}

Affiliations

¹ From 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.
² C.E. Barber, MD, FRCPC, PhD, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, and Research Scientist, Arthritis Research Canada; L. Jewett, MGIS (Candidate), Department of Geography, University of Calgary; E.M. Badley, PhD, Krembil Research Institute, Toronto Western Hospital, and Dalla Lana School of Public Health, University of Toronto; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Canada; A. Cividino, MD, FRCPC, Professor, Division Director, Rheumatology, McMaster University; V. Ahluwalia, MD, FRCPC, Corporate Chief of Rheumatology, William Osler Health System; H. Averns, MB, ChB, FRCP ( UK), FRCPC, Rheumatologist, Private Practice; C. Baillie, MD, FRCPC, Assistant Professor, University of Manitoba, and Past President Canadian Rheumatology Association; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; J. Pope, MD, MPH, FRCPC, Professor of Medicine, Division of Rheumatology, University of Western Ontario; D. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, and Assistant Professor of Pediatrics, University of Toronto; C. Charnock, CAE, CEO/PDF, Canadian Rheumatology Association; C. McGowan, Project Coordinator, Canadian Rheumatology Association; J.C. Thorne, MD, FRCPC, Assistant Professor, University of Toronto, and Medical Director, The Arthritis Program at Southlake Regional Health Centre; C. Barnabe, MD, MSc, FRCPC, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary; M. Zummer, MD, FRCPC, Chief, Rheumatology, Hôpital Maisonneuve-Rosemont, and Associate Professor, Université de Montréal; K. Lundon, BScPT, MSc, PhD, Advanced Clinician Practitioner in Arthritis Care, Program Director, Faculty of Medicine, University of Toronto; R.S. McDougall, MD, FRCPC, Clinical Professor, University of Saskatchewan; J.G. Thomson, MD, FRCPC, Assistant Professor, Department of Medicine, Division of Rheumatology, University of Ottawa; E.A. Yacyshyn, MD, FRCPC, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine, University of Alberta; D. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; J. Brophy, MD, FRCPC, Rheumatologist, Private Practice; T.N. Ruban, MD, FRCPC, Rheumatologist, Private Practice; D.A. Marshall, PhD, Professor, Arthur J.E. Child Chair in Rheumatology Research, Department of Community Health Sciences, Cumming School of Medicine, and Division of Rheumatology, Department of Medicine, University of Calgary, McCaig Institute for Bone and Joint Health. cehbarbe@ucalgary.ca.
³ From 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.
⁴ C.E. Barber, MD, FRCPC, PhD, Assistant Professor, Division of Rheumatology, Department of Medicine, University of Calgary, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, and Research Scientist, Arthritis Research Canada; L. Jewett, MGIS (Candidate), Department of Geography, University of Calgary; E.M. Badley, PhD, Krembil Research Institute, Toronto Western Hospital, and Dalla Lana School of Public Health, University of Toronto; D. Lacaille, MD, FRCPC, MHSc, Professor, Division of Rheumatology, Department of Medicine, University of British Columbia, and Senior Scientist, Arthritis Research Canada; A. Cividino, MD, FRCPC, Professor, Division Director, Rheumatology, McMaster University; V. Ahluwalia, MD, FRCPC, Corporate Chief of Rheumatology, William Osler Health System; H. Averns, MB, ChB, FRCP ( UK), FRCPC, Rheumatologist, Private Practice; C. Baillie, MD, FRCPC, Assistant Professor, University of Manitoba, and Past President Canadian Rheumatology Association; J. Ellsworth, MD, FRCPC, Professor and Head, Division of Pediatric Rheumatology, Faculty of Medicine and Dentistry, University of Alberta; J. Pope, MD, MPH, FRCPC, Professor of Medicine, Division of Rheumatology, University of Western Ontario; D. Levy, MD, MS, FRCPC, Staff Rheumatologist, Hospital for Sick Children, and Assistant Professor of Pediatrics, University of Toronto; C. Charnock, CAE, CEO/PDF, Canadian Rheumatology Association; C. McGowan, Project Coordinator, Canadian Rheumatology Association; J.C. Thorne, MD, FRCPC, Assistant Professor, University of Toronto, and Medical Director, The Arthritis Program at Southlake Regional Health Centre; C. Barnabe, MD, MSc, FRCPC, Associate Professor, Departments of Medicine and Community Health Sciences, University of Calgary; M. Zummer, MD, FRCPC, Chief, Rheumatology, Hôpital Maisonneuve-Rosemont, and Associate Professor, Université de Montréal; K. Lundon, BScPT, MSc, PhD, Advanced Clinician Practitioner in Arthritis Care, Program Director, Faculty of Medicine, University of Toronto; R.S. McDougall, MD, FRCPC, Clinical Professor, University of Saskatchewan; J.G. Thomson, MD, FRCPC, Assistant Professor, Department of Medicine, Division of Rheumatology, University of Ottawa; E.A. Yacyshyn, MD, FRCPC, Associate Professor of Medicine, Division of Rheumatology, Department of Medicine, University of Alberta; D. Mosher, MD, FRCPC, Chief, Division of Rheumatology, Department of Medicine, University of Calgary; J. Brophy, MD, FRCPC, Rheumatologist, Private Practice; T.N. Ruban, MD, FRCPC, Rheumatologist, Private Practice; D.A. Marshall, PhD, Professor, Arthur J.E. Child Chair in Rheumatology Research, Department of Community Health Sciences, Cumming School of Medicine, and Division of Rheumatology, Department of Medicine, University of Calgary, McCaig Institute for Bone and Joint Health.

PMID: 27909087
DOI: 10.3899/jrheum.160621

Abstract

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.

Keywords: ADULT RHEUMATOLOGIST; PEDIATRIC RHEUMATOLOGIST; RHEUMATOLOGIST; WORKFORCE.

MeSH terms

Canada
Health Services Needs and Demand
Health Workforce*
Humans
Rheumatology*
Surveys and Questionnaires