The provision of specialist rheumatology care: implications from a survey of rheumatologists in Ontario, Canada

Abstract

Objective: To describe the practice characteristics and whereabouts of rheumatologists in Ontario, Canada in order to make inferences regarding the current status of clinical rheumatology services.

Methods: All 136 identified Ontario rheumatologists received a self-administered, mailed questionnaire.

Results: The adjusted response rate was 74.2%. For respondents, there was a mean of 14.4 years in practice (1-42 years), 74.7% were male, and 91.3% were practising in urban and/or suburban locations. Only 6 were practising principally in remote northern locations. Sixty-three percent of respondents had a university faculty appointment; 40.4% geographic full time (GFT) and 22.3% clinical only. University appointed rheumatologists, and in particular those with GFT status, were more likely to have a particular clinical focus (p < 0.0001), saw fewer patients on fewer half days/week (p < 0.0001 and p = 0.0001, respectively), had longer waiting times to see a new patient (9.8 weeks for GFT versus 5.9 weeks and 7.0 weeks for clinical only and nonappointed, respectively; p = 0.009), and had greater research, teaching and administrative duties (p < or = 0.0001 for each). University appointment was not associated with the likelihood of having additional nonrheumatology clinical responsibilities.

Conclusion: A major proportion of rheumatologists in Ontario are university based with significant research, teaching, and administrative responsibilities, which limits their availability as consultants. These findings have implications for the future training of rheumatologists and for future studies of rheumatology manpower requirements.