The BC Society of Rheumatologists (BCSR), in collaboration with the UBC Faculty of Medicine—Division of Rheumatology, announced the results, Oct. 28, of a two-part study of rheumatology care in the province.
In addition to identifying the B.C. communities experiencing the most severe shortage of rheumatologists (Kelowna, Surrey and Prince George), the study examined wait times for two types of rheumatology consult requests in British Columbia.
Rheumatologists are sub-specialists of internal medicine and care for patients with systemic auto-immune diseases such as rheumatoid arthritis, lupus, vasculitis, gout and inflammatory diseases of the back, as well as complicated musculoskeletal problems such as advanced osteoarthritis.
These are the main findings of the BCSR’s study.
1. Communities of Need
Studies have previously shown that there is a shortage of rheumatologists in B.C., but this is the first research to clearly identify the most under-served communities:
Kelowna also serves as a referral centre for a large region and is currently under-serviced. Wait times to see a rheumatologist are among the highest in B.C. Increasing numbers of patients are travelling to the Lower Mainland for rheumatologic services.
Surrey has a population of close to 500,000; however, according to the College of Physicians and Surgeons of B.C., there are no actively practicing Royal College-certified rheumatologists in the city. The need for rheumatologists will only escalate with Surrey’s rapidly expanding population and economic growth.
Despite being a medical training facility for UBC, there are no active rheumatologists in Prince George. The city also serves as a referral area for a large catchment of the north, making Prince George and the surrounding area highly under-serviced.
“It is extremely concerning that two large regions—Surrey and Prince George—do not have a single practicing rheumatologist, and that another large region, Kelowna, experiences some of the longest wait times in the province,” said Dr. Jason Kur, president of BC Society of Rheumatologists and Clinical Assistant Professor, UBC Faculty of Medicine—Division of Rheumatology.
Dr. Kur added, “Now that we have quantifiable geographical data, we can work with our partners to recruit new graduates and out-of-province rheumatologists to practice in those communities, as well as encourage new medical students to specialize in rheumatology.”
2. Wait times for consults
The research team also conducted a population-based study of the time from consultation request by a family practitioner to booking of the visit with a rheumatologist in British Columbia (using fictitious referrals).
The study focused on two types of rheumatology patients: those with rheumatoid arthritis (RA) and osteoarthritis (OA). The majority (93 per cent) of B.C. rheumatologists booked an RA patient for consultation within 90 days of the request, which is within the guidelines set by the Canadian Rheumatology Association.
The wait time for OA patients was significantly longer, meaning that B.C. rheumatologists prioritize early RA patients over OA cases. The average wait time for OA patients is about 200 days, with some areas experiencing waits of up to 500 days.
“The survey data provides a more clear picture of how the shortage of rheumatologists impacts different patients and regions of the province,” said Dr. Kur. “The BCSR can now take these findings and work with stakeholders to address care where the demand is greatest.
“Our ultimate goal is to improve overall delivery of rheumatologic care in the province, and the data will help us to do this,” Kur said.
About Dr. Jason Kur:
Dr. Jason Kur is a medical director of the Artus Health Centre in Vancouver. He is a member of the clinical staff of Vancouver General Hospital. http://artushealth.com
About the BC Society of Rheumatologists (BCSR):
The BC Society of Rheumatologists is committed to advancing the quality of care for patients in British Columbia with systemic autoimmune diseases and arthritis through advocacy and leadership. www.bcrheumatology.ca