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Sautner J, Puchner R, Reisch M, Alkin A, Duftner C, Dejaco C. Professional development is the key to securing a future rheumatology workforce. Long term evaluation of a summer school for medical students-a national scientific society's educational initiative. Front Med (Lausanne) 2024; 11:1413544. [PMID: 39296892 PMCID: PMC11409003 DOI: 10.3389/fmed.2024.1413544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 08/22/2024] [Indexed: 09/21/2024] Open
Abstract
Objectives A cumulative imbalance between rheumatologic need and an inadequate number of young colleagues entering the field leads to a dearth of rheumatologists in the near future. The Austrian Society for Rheumatology and Rehabilitation (ÖGR) has been organizing an annual Rheumatology Summer School (RSS) for medical students since 2017. The aim of this study was to analyze the annual RSS evaluations, the RSS' overall effects on attracting new talent into the field and the lasting promotion of rheumatology. Methods A questionnaire was distributed immediately after each RSS meeting. Additionally, we conducted an electronic survey among RSS participants (2017-2022) to assess their career development trajectories. Results From 2017-2023, a total of 220 students attended the RSS. They all completed the annual evaluation. Accordingly, students' expectations were met in 80% (2017) to 97% (2023) of cases. The electronic survey was completed by 64/133 (48%) students; 49 (77%) indicated that the RSS had markedly increased their desire to specialize in rheumatology. Among the 36 graduates, 10 (28%) had already been working in the field of rheumatology and 6 (17%) were considering this specialty but had not decided yet. RSS attendees in their 6th study year were influenced to a greater extent by the RSS to choose rheumatology as their primary specialty than 4th or 5th year students. The participants indicated that they benefited most from the RSS in terms of knowledge gain, personal awareness of rheumatology, networking among fellow students as well as gaining access to RSS faculty. Conclusion The RSS enhanced students' intention to choose rheumatology, particularly in those close to graduation, and led to increased awareness and deeper knowledge about rheumatology.
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Affiliation(s)
- Judith Sautner
- Department of Medicine II, Lower Austrian Centre for Rheumatology, Karl Landsteiner Institute for Clinical Rheumatology, State Hospital Korneuburg-Stockerau, Stockerau, Austria
- Austrian Society for Rheumatology and Rehabilitation (ÖGR), Stockerau, Austria
| | - Rudolf Puchner
- Austrian Society for Rheumatology and Rehabilitation (ÖGR), Stockerau, Austria
- Danube Private University, Krems, Austria
| | - Myriam Reisch
- Austrian Society for Rheumatology and Rehabilitation (ÖGR), Stockerau, Austria
- Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria
| | - Alois Alkin
- Medical Association of Upper Austria, Quality Management, Linz, Austria
| | - Christina Duftner
- Austrian Society for Rheumatology and Rehabilitation (ÖGR), Stockerau, Austria
- Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck/Tirol Kliniken GmbH, Innsbruck, Austria
| | - Christian Dejaco
- Austrian Society for Rheumatology and Rehabilitation (ÖGR), Stockerau, Austria
- Department of Rheumatology and Immunology, Medical University Graz, Graz, Austria
- Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck/Tirol Kliniken GmbH, Innsbruck, Austria
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Migowa AN, Hamdi W, Hashad S, Etayari H, Abushhaiwia A, Ferjani H, Nessib DB, Kharrat L, Fazaa A, Owino L, Faleye A, Owusu SA, Mosa DM, Eissa M, Nasef SI, Elsehrawy GG, Odhiambo R, Orwa J, Abu-Zaid MH. Development of the paediatric society of the African league against rheumatism (PAFLAR) JIA registry and clinical profile of JIA in Africa from the PAFLAR JIA registry. Pediatr Rheumatol Online J 2024; 22:67. [PMID: 39039515 PMCID: PMC11264440 DOI: 10.1186/s12969-024-01000-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 06/21/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND The spectrum of Juvenile Idiopathic Arthritis (JIA) in Africa is still largely unknown. We thus set out to illustrate how we set up the PAFLAR JIA registry and describe the clinical profile of Juvenile Idiopathic Arthritis across various regions in Africa. METHODS We carried out a retrospective observational cohort study where collaborators were trained on use of the existing PAFLAR REDCAP database to enter data for the JIA patients currently under their care capturing their epidemiological data, clinical features, laboratory investigations, diagnosis and therapy at initial diagnosis. Descriptive statistics including means, standard deviations, medians, interquartile ranges (IQR) for continuous variables and proportions for categorical variables were calculated as appropriate. Tests for difference between groups were performed between categorical variables using Pearson's chi-square or Fisher's exact tests. All analyses were performed using SPSS version 22 software. RESULTS We enrolled 302 patients, 58.6% (177 of 302) of whom were female. The median age of disease onset was 7 years (range 3-11 years) and the median age at diagnosis was 8.5 years (range 5-12 years). The median duration delay in diagnosis was 6 months (range 1-20.8 months). The JIA categories included Systemic JIA 18.9% (57), Oligoarticular JIA 19.2% (83), Polyarticular RF + ve 5% (15), Polyarticular RF-ve 17.9% (54), Enthesitis Related Arthritis (ERA) 18.2% (55), Psoriatic Arthritis 7% (21) and undifferentiated JIA 5.6% (17). As regards treatment the commonest therapies were NSAID therapy at 31.1%, synthetic DMARDs at 18.1%, synthetic DMARDs combined with NSAIDs at 17.5% and steroid therapy at 9.6%. Biological DMARDs accounted for 2.3% of therapies offered to our patients at diagnosis. The average JADAS score was 10.3 (range 4.8-18.2) and the average CHAQ score was 1.3 (range 0.7-2.0). CONCLUSION Our study highlights strategies involved in setting up a Pan-African paediatric rheumatology registry that embraces our broad diversity and the vast spectrum of JIA in Africa while comparing the various therapies available to our patients. The PAFLAR JIA registry strives to ensure a comprehensive representation of the diverse healthcare landscapes within the continent. Further longitudinal observation studies are required to ascertain the long-term outcomes of our patients and ultimately help inform policy to create a more favorable health ecosystem to support the healthcare needs of JIA patients in Africa.
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Affiliation(s)
- Angela Nyangore Migowa
- Department of Paediatrics, Aga Khan University Medical College East Africa Nairobi, P.O Box 30270, Nairobi, 00100, Kenya.
| | - Wafa Hamdi
- Department of Rheumatology, Kassab Institute - Tunis El Manar University - Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Soad Hashad
- Tripoli Children's Hospital, University of Tripoli, Tripoli, Libya
| | - Hala Etayari
- Tripoli Children's Hospital, University of Tripoli, Tripoli, Libya
| | | | - Hanene Ferjani
- Rheumatology Department, Kassab Institute of Orthopedics, Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Dorra Ben Nessib
- Department of Rheumatology, Kassab Institute - Tunis El Manar University - Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Lobna Kharrat
- Department of Rheumatology, Kassab Institute - Tunis El Manar University - Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Alia Fazaa
- Department of Rheumatology, Mongi Slim Hospital - Tunis El Manar University - Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Lawrence Owino
- Department of Paediatrics, Faculty of Health Sciences Nairobi, University of Nairobi, Nairobi, Kenya
| | - Ayodele Faleye
- Department of Paediatrics, Lagos State University Teaching Hospital Lagos, Lagos, Nigeria
| | - Sheila Agyeiwaa Owusu
- Department of Paediatrics and Child Health, University for Development Studies, Tamale, Ghana
| | - Doaa Mosad Mosa
- Department of Rheumatology and Rehabilitation, Faculty of Medicine, Mansoura University Hospital, Mansoura, Egypt
| | - Mervat Eissa
- Department of Rheumatology, Cairo University, Cairo, Egypt
| | | | | | - Rachel Odhiambo
- Research Unit, Aga Khan University Medical College East Africa Nairobi, Nairobi, Kenya
| | - James Orwa
- Department of Population Health, Aga Khan University Medical College East Africa Nairobi, Nairobi, Kenya
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Avouac J, Marotte H, Balsa A, Chebbah M, Clanche SL, Verhagen LAW, Filková M, Mueller RB, Mongey AB, Taylor PC. Teleconsultation in rheumatology: A literature review and opinion paper. Semin Arthritis Rheum 2023; 63:152271. [PMID: 37813005 DOI: 10.1016/j.semarthrit.2023.152271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 08/18/2023] [Accepted: 08/27/2023] [Indexed: 10/11/2023]
Abstract
In this article, we review published literature on "telerheumatology", a term describing the use of telemedicine in rheumatology. This field has received considerable recent attention through the development of efficient digital technologies, resulting in a good level of satisfaction among patients and health care professionals. In 2020, the social distancing constraints during the COVID-19 pandemic accelerated more widespread adoption worldwide. Telerheumatology is particularly suited for patients with rheumatoid arthritis who have achieved a sustained therapeutic target of remission or low disease activity. To facilitate remote consultations and meet expectations of rheumatologists and patients, international and national guidelines have recently been proposed and existing tools, such as Patient-Reported Outcomes questionnaires, have had to be digitally adapted. In addition, telerheumatology toolkits are proposed by the Arab League of Associations for Rheumatology (ArLAR), the Association of American Medical College (AAMC), and the American College of Rheumatology (ACR) for all learners, from medical students to practicing clinicians, encouraging the acquisition of telehealth skills and facilitating their integration into their routine clinical practice. The main benefits reported for this mode of health care are greater access to specialty care, flexibility, reduced rates of missed appointments, as well as improved patient engagement and autonomy. Limitations include the absence of physical examination. However, to implement telerheumatology effectively and widely in daily clinical practice, some barriers still need to be addressed. These include training of health care professionals, technological restrictions and reimbursement mechanisms. Despite the advantages of telerheumatology, it is not intended to replace face-to-face visits, but rather as a way to enhance access to care, service delivery and health care support for patients.
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Affiliation(s)
- Jérôme Avouac
- Service de Rhumatologie, Hôpital Cochin, AP-HP Centre - Université Paris Cité, 75014 Paris, France
| | - Hubert Marotte
- SAINBIOSE, INSERM U1059, Université Jean Monnet, Saint-Etienne, France; Service de Rhumatologie, CHU Saint-Etienne,42055 Saint-Etienne, France; CIC 1408, Saint-Etienne, France
| | - Alejandro Balsa
- Rheumatology Unit, University Hospital La Paz, Institute for Health Research-IdiPAZ, Universidad Autonoma de Madrid,28046 Madrid, Spain
| | - Myriam Chebbah
- Public Health Expertise, Département Affaires Médicales, 10 boulevard de Sébastopol, 75004 Paris, France
| | - Solenn Le Clanche
- Public Health Expertise, Département Affaires Médicales, 10 boulevard de Sébastopol, 75004 Paris, France
| | | | - Mária Filková
- Institute of Rheumatology, Department of Rheumatology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | | | - Peter C Taylor
- Norman Collison Professor of Musculoskeletal Sciences at the Botnar Research Centre, NDORMS, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK.
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4
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Ziade N, Hmamouchi I, Haouichat C, Baron F, Al Mayouf S, Abdulateef N, Masri B, El Rakawi M, El Kibbi L, El Mashaleh M, Elzorkany B, Al Saleh J, Dejaco C, Abutiban F. The rheumatology workforce in the Arab countries: current status, challenges, opportunities, and future needs from an ArLAR cross-sectional survey. Rheumatol Int 2023; 43:2281-2292. [PMID: 37624401 DOI: 10.1007/s00296-023-05427-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/07/2023] [Indexed: 08/26/2023]
Abstract
The Arab League of Associations for Rheumatology (ArLAR) Research Group (ARCH) conducted this study to investigate the number of current practicing rheumatologists in the Arab countries, to estimate the projected number of rheumatologists in 10 years, and to evaluate the current workload, practice profile, consultation waiting time, and geographical mobilities of these rheumatologists. This cross-sectional survey study was conducted in 16 Arab countries in two parts. The first survey was addressed nominally to national societies to estimate the current and projected workforce. The second was an anonymous e-survey elaborated by the study steering committee on the Google Forms platform and distributed to Arab rheumatologists using social media, WhatsApp, and mass e-mails to evaluate their practice. The mean number of rheumatologists in Arab countries was 0.84 per 100,000 inhabitants (mean age 47.5 years, 55% females), ranging from 0.06 (Sudan) to 1.86 (Tunisia). The number of rheumatologists is expected to increase by 50% in 2032. Nevertheless, a 20% increase in population associated with an increase in demand is also expected. Data from 446 rheumatologists (mean age 43.9 years, 60.5% females) revealed that 72% worked full-time, and 53% were employed in the public sector only. The average waiting time for a rheumatology consultation was 19.9 days. Of 394 rheumatologists, 19% obtained their rheumatology diplomas from non-Arab countries, and 47% of Gulf rheumatologists were non-citizen physicians. Considering local demographic disparities, healthcare system differences, and geographical mobilities, national authorities are advised to implement effective intervention plans to optimize the rheumatology workforce.
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Affiliation(s)
- Nelly Ziade
- Rheumatology Department, Saint-Joseph University, Beirut, Lebanon.
- Tour Des Consultations Externes, Hotel-Dieu de France Hospital, 6th Floor, Alfred Naccache blvd., Achrafieh, Beirut, Lebanon.
| | - Ihsane Hmamouchi
- Laboratory of Clinical Research and Epidemiology, Faculty of Medicine, Mohammed V University, Rabat, Morocco
- Department of Medicine, Health Sciences College, International University of Rabat (UIR), Rabat, Morocco
| | - Chafika Haouichat
- Rheumatology Department, Djillali Bounaama University Hospital, Douera, Algeria
- Rheumatology Department, Faculty of Medicine El Mahdi Si Ahmed, Blida, Algeria
| | - Fatemah Baron
- Unit of Rheumatology, Internal Medicine Department, Al-Jahra Hospital, Ministry of Health, Kuwait City, State of Kuwait
| | - Sulaiman Al Mayouf
- Division of Rheumatology, Department of Pediatrics, King Faisal Specialist Hospital and Research Center. College of Medicine, Al Faisal University, Riyadh, Saudi Arabia
| | - Nizar Abdulateef
- Rheumatology Unit, Department of Medicine, College of Medicine, University of Baghdad, Baghdad, Iraq
| | - Basel Masri
- Rheumatology Division, Department of Internal Medicine, Jordan Hospital and Medical Center, Amman, Jordan
| | - Manal El Rakawi
- Rheumatology Department, Faculty of Medicine El Mahdi Si Ahmed, Blida, Algeria
| | - Lina El Kibbi
- Division of Rheumatology, Department of Internal Medicine, Specialized Medical Center, Riyadh, Saudi Arabia
| | - Manal El Mashaleh
- Rheumatology Division of Internal Medicine, King Hussein Medical Center, Royal Medical Services, Jordan Armed Forces, Amman, Jordan
| | | | | | - Christian Dejaco
- Department of Rheumatology and Immunology, Medical University of Graz, Graz, Austria
- Department of Rheumatology, Hospital of Bruneck (ASAA-SABES), Brunico, Italy
| | - Fatemah Abutiban
- Unit of Rheumatology, Department of Internal Medicine, Jaber Alahmed Hospital, Ministry of Health, Kuwait City, State of Kuwait
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5
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Sautner J, Grabner I, Posch A, Duftner C. How to plug the leaky pipeline in clinical rheumatology across Europe-lessons to be learned from experiences in business. Rheumatology (Oxford) 2023; 62:3538-3546. [PMID: 36857573 DOI: 10.1093/rheumatology/kead090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 02/12/2023] [Accepted: 02/14/2023] [Indexed: 03/03/2023] Open
Abstract
OBJECTIVES While >50% of medical students and residents are women, their proportion drastically diminishes within higher ranks and leadership roles; this is known as the 'leaky pipeline'. We aimed to evaluate the leaky pipeline among rheumatologists across Europe and to assess determinants inducing rheumatologists to leave hospitals. METHODS Experts in the field of economics developed a questionnaire with scientific focus on the leaky pipeline among rheumatologists, which was distributed electronically by national scientific societies of EULAR countries and by individual contacts. We performed common factor analysis, univariate t-tests and multivariate regression analyses to appraise our dataset. RESULTS A total of 311 hospital-based rheumatologists from 23/45 EULAR countries (52.7% females, 47.3% males) answered the questionnaire. The presence of the leaky pipeline was evident for the entire sample. Of 64% female rheumatologists only 34.2% of departments' directors were female, with noteworthy regional differences. Female doctors reported higher intentions to leave their hospital (β = 0.28, P < 0.05) and lower commitment towards their current organization (β = -0.34, P < 0.05) when compared with males. Women reported lower levels of job satisfaction (β = -0.26, P < 0.10), promotion justice (β = -0.55, P < 0.01) and career perspectives (β = -0.26, P < 0.10, one-tailed) than men, explaining their lower organizational commitment. CONCLUSION Female rheumatologists perceive worse job opportunities and satisfaction than males. Many reasons for the leaky pipeline are beyond the control of organizations. Based on our results, organizations should be encouraged to reconsider and adjust their performance management practices to enable an equitable work environment.
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Affiliation(s)
- Judith Sautner
- Department of Medicine II, Lower Austrian Centre for Rheumatology, Karl Landsteiner Institute for Clinical Rheumatology, State Hospital Stockerau, Stockerau, Austria
| | - Isabella Grabner
- Institute for Strategy and Managerial Accounting, Vienna University of Economics and Business, Vienna, Austria
| | - Arthur Posch
- Department of Business, Institute of Tourism, Wine Business and Marketing, IMC University of Applied Sciences Krems, Krems, Austria
- Institute for Accounting, University of Bern, Bern, Switzerland
| | - Christina Duftner
- Department of Internal Medicine, Clinical Division of Internal Medicine II, Medical University of Innsbruck/Tirol Kliniken GmbH, Innsbruck, Austria
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6
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Kuhlmann E, Bruns L, Hoeper K, Witte T, Ernst D, Jablonka A. [Health workforce development in rheumatology : A mapping exercise and wake-up call for health policy]. Z Rheumatol 2022; 81:717-729. [PMID: 34003376 PMCID: PMC8129704 DOI: 10.1007/s00393-021-01012-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVE Health workforce shortage in German rheumatology has been identified as a healthcare service and delivery problem. Health policy has increased staffing targets, yet effective intervention strategies are lacking. This research aimed to systematically map the rheumatology workforce to improve the evidence for interventions and explore possibilities for more effective health workforce management. METHODS The WHO National Health Workforce Accounts provided a conceptual framework for the mapping exercise. Four major sets of indicators were selected, comprising staffing levels, health labor market flows, composition and education/training. A comparison of age groups and time series was applied to explore trends. Public statistics and other secondary sources served our analysis using descriptive methodology. RESULTS In Germany there are 1076 physicians specialized in internal medical rheumatology. Absolute numbers have nearly doubled (91%) since 2000 but with a strong demographic bias. Between 2000 and 2019 numbers markedly increased in the group aged 50 years and older but only by 9% in the younger group under 50 years; since 2010 the group aged 40-50 years even faces a decrease. In 2019, the absolute numbers of rheumatologists in retirement age exceeded those aged 40 years and under. Since 2015 an expanding workforce trend has overall flattened but this was strongest in the hospital sector; the numbers in resident training did not show any relevant growth. CONCLUSION Health workforce trends reveal that an available number of rheumatologists cannot meet new health policy planning targets. There is a need for effective health workforce management, focusing on innovation in resident training, improved task delegation and gender equality.
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Affiliation(s)
- Ellen Kuhlmann
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Luzia Bruns
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Kirsten Hoeper
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
- Regionales Kooperatives Rheumazentrum Niedersachsen e. V., Hannover, Deutschland
| | - Torsten Witte
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Diana Ernst
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Alexandra Jablonka
- Klinik für Rheumatologie und Immunologie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
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7
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Sánchez-Piedra C, Álvaro-Gracia JM, Bustabad-Reyes S, Díaz-González F. The reality of Rheumatology in Spain and its autonomous communities before the pandemic. REUMATOLOGIA CLINICA 2022; 18:486-489. [PMID: 35504825 DOI: 10.1016/j.reumae.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/21/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To determine the number of rheumatologists per 100,000 inhabitants working in public or private centres in Spain as a whole, and by Autonomous Community and their distribution by age and sex. MATERIAL AND METHOD Cross-sectional study based on the information contained in the database of the Spanish Society of Rheumatology. Quality control was performed by contact (e-mail and telephone call) with the heads of the clinical services of each of the hospitals (public and private). The information analysed was the age, sex and place of work of active rheumatologists in February 2020. The rates of rheumatologists per 100,000 inhabitants were calculated from population data from the National Institute of Statistics. RESULTS The rate of rheumatology specialists per 100,000 inhabitants in Spain was estimated at 2.17. The percentage of women was 59.7%, with a higher female/male ratio at younger ages. The lowest proportion of specialists per 100,000 inhabitants was in the community of Valencia (1.6), and the highest in Cantabria (3.2). CONCLUSIONS Variations were found in the rate of rheumatologists per 100,000 inhabitants among the Autonomous Communities. The distribution by age and sex showed a tendency towards female rheumatologists, especially in the younger age strata.
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Affiliation(s)
| | | | | | - Federico Díaz-González
- Hospital Universitario de Canarias, San Cristobal de la Laguna, Spain; Departamento de Medicina, Dermatología y Psiquiatría, Universidad de La Laguna, San Cristóbal de La Laguna, Spain.
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8
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Ovseiko PV, Gossec L, Andreoli L, Kiltz U, van Mens L, Hassan N, van der Leeden M, Siddle HJ, Alunno A, McInnes IB, Damjanov NS, Apparailly F, Ospelt C, van der Horst-Bruinsma IE, Nikiphorou E, Druce KL, Szekanecz Z, Sepriano A, Avcin T, Bertsias G, Schett G, Keenan AM, Pololi LH, Coates LC. Gender equity in academic rheumatology, current status and potential for improvement: a cross-sectional study to inform an EULAR task force. RMD Open 2022; 8:rmdopen-2022-002518. [PMID: 35940824 PMCID: PMC9367178 DOI: 10.1136/rmdopen-2022-002518] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/13/2022] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES Evidence on the current status of gender equity in academic rheumatology in Europe and potential for its improvement is limited. The EULAR convened a task force to obtain empirical evidence on the potential unmet need for support of female rheumatologists, health professionals and non-clinical scientists in academic rheumatology. METHODS This cross-sectional study comprised three web-based surveys conducted in 2020 among: (1) EULAR scientific member society leaders, (2) EULAR and Emerging EULAR Network (EMEUNET) members and (3) EULAR Council members. Statistics were descriptive with significance testing for male/female responses assessed by χ2 test and t-test. RESULTS Data from EULAR scientific member societies in 13 countries indicated that there were disproportionately fewer women in academic rheumatology than in clinical rheumatology, and they tended to be under-represented in senior academic roles. From 324 responses of EULAR and EMEUNET members (24 countries), we detected no gender differences in leadership aspirations, self-efficacy in career advancement and work-life integration as well as the share of time spent on research, but there were gender differences in working hours and the levels of perceived gender discrimination and sexual harassment. There were gender differences in the ranking of 7 of 26 factors impacting career advancement and of 8 of 24 potential interventions to aid career advancement. CONCLUSIONS There are gender differences in career advancement in academic rheumatology. The study informs a EULAR task force developing a framework of potential interventions to accelerate gender-equitable career advancement in academic rheumatology.
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Affiliation(s)
- Pavel V Ovseiko
- Radcliffe Department of Medicine, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Laure Gossec
- Institut Pierre Louis d'Epidémiologie et de Santé Publique, INSERM, Sorbonne Universite, Paris, France.,Rheumatology Department, APHP.Sorbonne Universite, Hopital Universitaire Pitie Salpetriere, Paris, France
| | - Laura Andreoli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.,Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili di Brescia, Brescia, Italy
| | - Uta Kiltz
- Department of Rheumatology, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany
| | - Leonieke van Mens
- Department of Clinical Immunology and Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam, The Netherlands
| | - Neelam Hassan
- Department of Rheumatology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK.,Musculoskeletal Research Unit, University of Bristol, Bristol, UK
| | - Marike van der Leeden
- Department of Rehabilitation Medicine, Amsterdam Movement Sciences, Reade Centre for Rehabilitation and Rheumatology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Heidi J Siddle
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,NIHR Leeds Musculoskeletal Biomedical Research Centre, Leeds, UK
| | - Alessia Alunno
- Internal Medicine and Nephrology Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Iain B McInnes
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
| | - Nemanja S Damjanov
- University of Belgrade School of Medicine, Medigroup Hospital, Rheumatology, Belgrade, Serbia
| | | | - Caroline Ospelt
- Center of Experimental Rheumatology, Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland.,University of Zurich, Zurich, Switzerland
| | | | - Elena Nikiphorou
- Rheumatology Department, King's College Hospital, London, UK.,Centre for Rheumatic Diseases, School of Immunology and Microbial Sciences, King's College London, London, UK
| | - Katie L Druce
- Centre for Epidemiology Versus Arthritis, Division of Musculoskeletal and Dermatological Sciences, The University of Manchester, Manchester, UK
| | - Zoltán Szekanecz
- Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Alexandre Sepriano
- Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.,NOVA Medical School, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Tadej Avcin
- Department of Allergology, Rheumatology and Clinical Immunology, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - George Bertsias
- Department of Rheumatology, Clinical Immunology and Allergy, University of Crete Medical School, Heraklion, Greece
| | - Georg Schett
- Deutsches Zentrum für Immuntherapie, Friedrich-Alexander-University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Department of Internal Medicine 3, Friedrich-Alexander-University Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Anne-Maree Keenan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK.,School of Healthcare, University of Leeds, Leeds, UK.,NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Linda H Pololi
- National Initiative on Gender, Culture and Leadership in Medicine: C-Change, Women's Studies Research Center, Brandeis University, Waltham, Massachusetts, USA
| | - Laura C Coates
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK .,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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9
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Kulhawy-Wibe SC, Widdifield J, Lee JJY, Thorne JC, Yacyshyn EA, Batthish M, Jerome D, Shupak R, Jilkine K, Purvis J, Shamis J, Roberts J, Kur J, Burt JE, Johnson NA, Barnabe C, Spencer N, Harrison M, Pope J, Barber CE. Results from the 2020 Canadian Rheumatology Association's Workforce and Wellness Survey. J Rheumatol 2022; 49:635-643. [DOI: 10.3899/jrheum.210990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 11/22/2022]
Abstract
Objective The Canadian Rheumatology Association (CRA) launched the Workforce and Wellness Survey to update the Canadian rheumatology workforce characteristics. Methods The survey included demographic and practice information, pandemic impacts, and the Mini-Z questionnaire to assess burnout. French and English survey versions were distributed to CRA members electronically between 10/14/2020-3/5/2021. The number of full-time equivalent (FTE) rheumatologists per 75,000 population was estimated from the median proportion of time in clinical practice multiplied by provincial rheumatologist numbers from the Canadian Medical Association (CMA). Results Forty-four percent (183/417) of the estimated practicing rheumatologists (149 adult; 34 pediatric) completed the survey. The median age was 47 years, 62% were female, and 28% planned to retire within the next 5-10 years. Respondents spent a median of 65% of their time in clinical practice. FTE rheumatologists per 75,000 ranged between 0 and 0.70 in each province/territory and 0.62 per 75,000 nationally. This represents a deficit of 1 to 78 FTE rheumatologists per province/territory and 194 FTE rheumatologists nationally to meet the CRA's workforce benchmark. Approximately half of survey respondents reported burnout (51%). Women were more likely to report burnout (OR 2.86, 95%CI: 1.42-5.93). Older age was protective against burnout (OR 0.95, 95%CI: 0.92, 0.99). As a result of the pandemic, 97% of rheumatologists reported spending more time engaged in virtual care. Conclusion There is a shortage of rheumatologists in Canada. This shortage may be compounded by the threat of burnout to workforce retention and productivity. Strategies to address these workforce issues are urgently needed.
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10
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Grados Canovas D, Martínez-Morillo M, Olivé Marques A, Retamero A, Nolla JM, Guanyabens N. Rheumatology manpower in the public system in Catalonia (Spain). REUMATOLOGIA CLINICA 2021; 17:607-610. [PMID: 34823829 DOI: 10.1016/j.reumae.2020.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Accepted: 06/17/2020] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To determine the current state of Rheumatology in Catalonia and to update the information regarding previous studies. MATERIAL AND METHODS DESIGN Observational, descriptive and cross-sectional study. Data collection from January to June 2017. SAMPLE Rheumatologists practising public healthcare activity in Catalonia. An online questionnaire was sent to gather individual data and data from rheumatology services/sections. RESULTS Information was obtained on 109 rheumatologists: 39 men and 70 women; mean age: 47±9 years. The number of rheumatologists has increased by 8% over the past 5 years. One hundred and one (92.7%) doctors qualified as rheumatologists through the MIR. Rheumatology practice was mostly in a hospital setting: 68 (62.4%) physicians. Ninety-six (88.1%) rheumatologists were full-time practitioners. Fifty-four (50%) rheumatologists also practiced in the private sector. Clinical practice was predominant: 76% of daily time was devoted to this area. Of note, it was found that most of the rheumatology services, 24 (705), were dependent hierarchically on other services, namely internal medicine and orthopaedic surgery. There are still 6 hospitals in Catalonia without a rheumatologist. CONCLUSIONS The number of rheumatologists in the public health sector of Catalonia has increased over the past 5 years. The mean age of rheumatologists is advanced and there is a clear predominance of female practitioners in the specialty. Many rheumatology services depend on other services. Rheumatology activity is primarily focussed in the city of Barcelona.
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Affiliation(s)
- Dolors Grados Canovas
- Servicio de Reumatología, Hospital d'Igualada, Consorci Sanitari de l'Anoia, Igualada, Barcelona, Spain.
| | - Melania Martínez-Morillo
- Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Alejandro Olivé Marques
- Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, Spain
| | - Alexandra Retamero
- Servicio de Farmacia, Hospital d'Igualada, Consorci Sanitari de l'Anoia, Igualada, Barcelona, Spain
| | - Joan M Nolla
- Servicio de Reumatología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Presidente de la Sociedad Catalana de Reumatología
| | - Núria Guanyabens
- Servicio de Reumatología, Hospital Clínic, Barcelona, Spain; Expresidenta de la Sociedad Catalana de Reumatología
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11
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Shamis J, Widdifield J, Batthish M, Mahendira D, Jamal S, Cividino A, Lethebe BC, Barber CE. Factors influencing rheumatology residents' decision on future practice location. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:e63-e68. [PMID: 33995721 PMCID: PMC8105565 DOI: 10.36834/cmej.70348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND There are regional disparities in the distribution of Canadian rheumatologists. The objective of this study was to identify factors impacting rheumatology residents' postgraduate practice decisions to inform Canadian Rheumatology Association workforce recommendations. METHODS An online survey was developed, and invitations were sent to all current Canadian rheumatology residents in 2019 (n = 67). Differences between subgroups of respondents were examined using the Pearson χ2 test. RESULTS A total of 34 of 67 residents completed the survey. Seventy-three percent of residents planned to practice in the same province as their rheumatology training. The majority of residents (80%) ranked proximity to friends and family as the most important factor in planning. Half of participants had exposure to alternative modes of care delivery (e.g. telehealth) during their rheumatology training with fifteen completing a community rheumatology elective (44%). CONCLUSIONS The majority of rheumatology residents report plans to practice in the same province as they trained, and close to home. Gaps in training include limited exposure to community electives in smaller centers, and training in telehealth and travelling clinics for underserviced populations. Our findings highlight the need for strategies to increase exposure of rheumatology trainees to underserved areas to help address the maldistribution of rheumatologists.
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Affiliation(s)
- Justin Shamis
- Division of Rheumatology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Jessica Widdifield
- Sunnybrook Research Institute, ICES, and Institute of Health Policy, Management & Evaluation, University of Toronto, Ontario, Canada
| | - Michelle Batthish
- Division of Rheumatology, Department of Pediatrics, McMaster University, Ontario, Canada
| | - Dharini Mahendira
- Division of Rheumatology, Department of Medicine, University of Toronto, Ontario, Canada
| | - Shahin Jamal
- Division of Rheumatology, Department of Medicine, University of British Columbia, British Columbia, Canada
| | - Alfred Cividino
- Division of Rheumatology, Department of Medicine, McMaster University, Ontario, Canada
| | - B Cord Lethebe
- Clinical Research Unit, University of Calgary, Alberta, Canada
| | - Claire E Barber
- Division of Rheumatology, Department of Medicine and Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
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12
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Kjeken I, Bergsmark K, Haugen IK, Hennig T, Hermann-Eriksen M, Hornburg VT, Hove Å, Prøven A, Sjøvold TA, Slatkowsky-Christensen B. Task shifting in the care for patients with hand osteoarthritis. Protocol for a randomized controlled non-inferiority trial. BMC Musculoskelet Disord 2021; 22:194. [PMID: 33593307 PMCID: PMC7888184 DOI: 10.1186/s12891-021-04019-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 01/26/2021] [Indexed: 12/02/2022] Open
Abstract
Background Current health policy states that patients with osteoarthritis (OA) should mainly be managed in primary health care. Still, research shows that patients with hand OA have poor access to recommended treatment in primary care, and in Norway, they are increasingly referred to rheumatologist consultations in specialist care. In this randomized controlled non-inferiority trial, we will test if a new model, where patients referred to consultation in specialist health care receive their first consultation by an occupational therapy (OT) specialist, is as safe and effective as the traditional model, where they receive their first consultation by a rheumatologist. More specifically, we will answer the following questions:
What are the characteristics of patients with hand OA referred to specialist health care with regards to joint affection, disease activity, symptoms and function? Is OT-led hand OA care as effective and safe as rheumatologist-led care with respect to treatment response, disease activity, symptoms, function and patient satisfaction? Is OT-led hand OA care equal to, or more cost effective than rheumatologist-led care? Which factors, regardless of hand OA care, predict improvement 6 and 12 months after baseline?
Methods Participants will be patients with hand OA diagnosed by a general practitioner and referred for consultation at one of two Norwegian departments of rheumatology. Those who agree will attend a clinical assessment and report their symptoms and function in validated outcome measures, before they are randomly selected to receive their first consultation by an OT specialist (n = 200) or by a rheumatologist (n = 200). OTs may refer patients to a rheumatologist consultation and vice versa. The primary outcome will be the number of patients classified as OMERACT/OARSI-responders after six months. Secondary outcomes are pain, function and satisfaction with care over the twelve-month trial period. The analysis of the primary outcome will be done by logistic regression. A two-sided 95% confidence interval for the difference in response probability will be formed, and non-inferiority of OT-led care will be claimed if the upper endpoint of this interval does not exceed 15%. Discussion The findings will improve access to evidence-based management of people with hand OA. Trial registration ClinicalTrials.gov, NCT03102788. Registered April 6th, 2017, https://clinicaltrials.gov/ct2/show/NCT03102788?term=Kjeken&draw=2&rank=1 Date and version identifier: December 17th, 2020. First version.
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Affiliation(s)
- Ingvild Kjeken
- National Advisory Unit on Rehabilitation in Rheumatology, Division of Rheumatology and Research, Diakonhjemmet Hospital, PO Box 23, Vinderen, N-0319, Oslo, Norway.
| | - Kjetil Bergsmark
- Division of Rheumatology and Research, Diakonhjemmet Hospital, PO Box 23, N-0319, Vinderen, Oslo, Norway
| | - Ida K Haugen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, PO Box 23, N-0319, Vinderen, Oslo, Norway
| | | | | | | | - Åshild Hove
- Division of Clinical Service, Diakonhjemmet Hospital, Oslo, Norway
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13
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Rautenstrauch J. [Translational healthcare research : Show what is-Angela Zink, the grande dame of public health research in rheumatology]. Z Rheumatol 2020; 79:975-982. [PMID: 33258975 DOI: 10.1007/s00393-020-00904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND As director of the program area epidemiology and health care research at the German Rheumatism Research Center, Angela Zink established the German National Database, a national register for the care of people with inflammatory rheumatic diseases and other important registers for public health research in rheumatology. OBJECTIVE This publication summarizes Angela Zink's life work and sheds light on the national significance of this extraordinary achievement from the background of the research results achieved. MATERIAL AND METHODS The available literature and personal memories of the author formed the basis of this summary. RESULTS The German National Database, which regularly collects data from more than 15,000 patients with inflammatory rheumatic diseases per year, shows that the prognosis has steadily improved in many areas, disease activity has decreased, the burden of illness due to pain or functional limitations has decreased, the incidence of incapacity for work and early retirement has decreased and those affected can nowadays participate to a much greater extent in social and working life; however, the data also revealed existing shortcomings, regional differences and differences between treatment by specialists or general practitioners. This made the database a central instrument of quality assurance. The biologics register RABBIT, in which side effects of biologics were registered and used for risk management, has also gained great importance. CONCLUSION The registers which were set up and systematically developed in the program area epidemiology under the leadership of Angela Zink, are a treasure trove of national importance. A continuation, even after the retirement of Angela Zink from active professional life, seems urgently necessary if the healthcare research of German rheumatology does not want to lose the international connection.
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Affiliation(s)
- Julia Rautenstrauch
- European League Against Rheumatism (EULAR), Seestr. 240, 8802, Kilchberg, Schweiz.
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14
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Grados Canovas D, Martínez-Morillo M, Olivé Marques A, Retamero A, Nolla JM, Guanyabens N. Rheumatology Manpower in the Public System in Catalonia (Spain). REUMATOLOGIA CLINICA 2020; 17:S1699-258X(20)30165-0. [PMID: 32798175 DOI: 10.1016/j.reuma.2020.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 06/10/2020] [Accepted: 06/17/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To determine the current state of Rheumatology in Catalonia and to update the information regarding previous studies. MATERIAL AND METHODS DESIGN Observational, descriptive and cross-sectional study. Data collection from January to June 2017. SAMPLE Rheumatologists practising public healthcare activity in Catalonia. An online questionnaire was sent to gather individual data and data from rheumatology services/sections. RESULTS Information was obtained on 109 rheumatologists: 39 men and 70 women; mean age: 47±9 years. The number of rheumatologists has increased by 8% over the past 5 years. One hundred and one (92.7%) doctors qualified as rheumatologists through the MIR. Rheumatology practice was mostly in a hospital setting: 68 (62.4%) physicians. Ninety-six (88.1%) rheumatologists were full-time practitioners. Fifty-four (50%) rheumatologists also practiced in the private sector. Clinical practice was predominant: 76% of daily time was devoted to this area. Of note, it was found that most of the rheumatology services, 24 (705), were dependent hierarchically on other services, namely internal medicine and orthopaedic surgery. There are still 6 hospitals in Catalonia without a rheumatologist. CONCLUSIONS The number of rheumatologists in the public health sector of Catalonia has increased over the past 5 years. The mean age of rheumatologists is advanced and there is a clear predominance of female practitioners in the specialty. Many rheumatology services depend on other services. Rheumatology activity is primarily focussed in the city of Barcelona.
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Affiliation(s)
- Dolors Grados Canovas
- Servicio de Reumatología, Hospital d'Igualada, Consorci Sanitari de l'Anoia, Igualada, Barcelona, España.
| | - Melania Martínez-Morillo
- Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Alejandro Olivé Marques
- Servicio de Reumatología, Hospital Universitari Germans Trias i Pujol, Badalona, Barcelona, España
| | - Alexandra Retamero
- Servicio de Farmacia, Hospital d'Igualada, Consorci Sanitari de l'Anoia, Igualada, Barcelona, España
| | - Joan M Nolla
- Servicio de Reumatología, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España; Presidente de la Sociedad Catalana de Reumatología
| | - Núria Guanyabens
- Servicio de Reumatología, Hospital Clínic, Barcelona, España; Expresidenta de la Sociedad Catalana de Reumatología
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15
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Puchner R, Vavrovsky A, Pieringer H, Hochreiter R, Machold KP. The Supply of Rheumatology Specialist Care in Real Life. Results of a Nationwide Survey and Analysis of Supply and Needs. Front Med (Lausanne) 2020; 7:16. [PMID: 32083088 PMCID: PMC7002545 DOI: 10.3389/fmed.2020.00016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 01/13/2020] [Indexed: 12/20/2022] Open
Abstract
Objectives: To study the balance between the supply and need for rheumatology care in Austria. In addition, to investigate rheumatologists' work-hours, the amount of time rheumatologists dedicate to care for patients with rheumatic and musculoskeletal diseases (RMD), with non-RMD problems, and other professional activities such as research, teaching, and administration. Methods: A questionnaire covering aspects of professional activities was sent to all 215 rheumatologists registered with the Austrian Medical Association. The data collected was set in relation to the need calculated on the basis of recommendations put forward by the German society of rheumatology. Results: 149 of the 215 rheumatologists (69.0%) responded. Median weekly working time was 50 h (IQR 45-60). 47.4% of the working time was spent for care of patients with RMD. The remaining time was dedicated to patients with non-rheumatic diseases (19.6%), research and teaching (8.4%), and administration (24.5%). The number of full-time equivalents (FTE, based on a 40-h work-week) available for rheumatology care, thus, was calculated to be 178.5. Based on disease prevalence/incidence estimates and on the time allocation results of this survey, our study resulted in a need of 4.29 rheumatologists per 100.000 adult inhabitants (301.79 for an adult population of 7.03 × 106). Conclusion: The study demonstrated a substantial mismatch between the available supply and the need for rheumatology care. The results of our study are a conservative estimate, which should be taken into consideration for future healthcare workforce planning. In particular, the rising need for rheumatologists should be met by increasing the numbers of those specialists.
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Affiliation(s)
| | | | | | - Ronald Hochreiter
- Department of Finance, Accounting and Statistics, Institute for Statistics and Mathematics, Vienna University of Economics and Business, Vienna, Austria
| | - Klaus P Machold
- Division of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
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