Skip to main content

Main menu

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • 50th Volume Reprints
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • JRheum Supplements
  • Services

User menu

  • My Cart
  • Log In

Search

  • Advanced search
The Journal of Rheumatology
  • JRheum Supplements
  • Services
  • My Cart
  • Log In
The Journal of Rheumatology

Advanced Search

  • Home
  • Content
    • First Release
    • Current
    • Archives
    • Collections
    • Audiovisual Rheum
    • 50th Volume Reprints
  • Resources
    • Guide for Authors
    • Submit Manuscript
    • Payment
    • Reviewers
    • Advertisers
    • Classified Ads
    • Reprints and Translations
    • Permissions
    • Meetings
    • FAQ
    • Policies
  • Subscribers
    • Subscription Information
    • Purchase Subscription
    • Your Account
    • Terms and Conditions
  • About Us
    • About Us
    • Editorial Board
    • Letter from the Editor
    • Duncan A. Gordon Award
    • Privacy/GDPR Policy
    • Accessibility
  • Contact Us
  • Follow Jrheum on BlueSky
  • Follow jrheum on Twitter
  • Visit jrheum on Facebook
  • Follow jrheum on LinkedIn
  • Follow jrheum on YouTube
  • Follow jrheum on Instagram
  • Follow jrheum on RSS
Research ArticleAccepted Article
Open Access

Encounters with Rheumatologists in a Publicly-Funded Canadian Healthcare System: A Population-Based Study

Jessica Widdifield, Sasha Bernatsky, Janet E. Pope, Vandana Ahluwalia, Claire E.H. Barber, Lihi Eder, Bindee Kuriya, Vicki Ling, J. Michael Paterson and Carter Thorne
The Journal of Rheumatology June 2019, jrheum.190034; DOI: https://doi.org/10.3899/jrheum.190034
Jessica Widdifield
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sasha Bernatsky
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Janet E. Pope
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vandana Ahluwalia
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Claire E.H. Barber
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Lihi Eder
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Bindee Kuriya
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vicki Ling
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
J. Michael Paterson
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Carter Thorne
Sunnybrook Research Institute, Holland Bone & Joint Program, Toronto, Ontario, Canada; University of Toronto, Institute of Health Policy, Management & Evaluation, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada; McGill University, Department of Epidemiology, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada; William Osler Health System, Brampton, Ontario, Canada; The Cumming School of Medicine, University of Calgary, Alberta, Canada; Arthritis Research Canada; Women’s College Research Institute, Toronto, Ontario, Canada; Sinai Health System, University of Toronto, Ontario, Canada; McMaster University, Department of Family Medicine, Hamilton, Ontario, Canada; Western University, Schulich School of Medicine & Dentistry, London, Ontario, Canada; St Joseph’s Health Care London, Ontario, Canada; Southlake Regional Health Centre, Newmarket, Ontario, Canada. This study was funded by an operating grant from the Canadian Initiative For Outcomes in Rheumatology Care (CIORA), who played no role in the design or conduct of the study, other than providing peer-review of the study proposal. Address correspondence to Jessica Widdifield Holland Bone & Joint Research Program, Sunnybrook Research Institute 2075 Bayview Avenue MG 352, Toronto ON, M4N 3M5. jessica.widdifield@utoronto.ca
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • References
  • PDF
Next
Loading

Abstract

Objective To quantify population-level and practice-level encounters with rheumatologists over time.

Methods We conducted a population-based study from 2000 to 2015 in Ontario, Canada, where all residents are covered by a single-payer healthcare system. Annual total number of unique patients seen by rheumatologists, the number of new patients seen, and total number of encounters with rheumatologists were identified.

Results From 2000 to 2015, the percentage of the population seen by rheumatologists was constant over time (2.7%). During this time, Ontario had a stable rheumatology supply (0.8 Full Time Equivalents (FTEs)/75,000). From 2000 to 2015, the number of annual rheumatology encounters increased from 561,452 to 742,952, but the adjusted encounter rates remained stable over time (at 62 encounters per 1000 population). New patient assessment rates declined over time from 10 new patient assessments per 1000 in 2000 to 6 per 1000 in 2015. The crude volume of new patients seen annually decreased and an increasing proportion of rheumatology encounters were with established patients. We observed a shift in patient case-mix over time, with more assessments for systemic inflammatory conditions. Rheumatologists’ practice volumes, practice sizes, and the annual number of days providing clinical care decreased over time.

Conclusion Over a 15-year period, the annual percentage of the population seen by a rheumatologist remained constant and the volume of new patients decreased, while follow up patient encounters increased. Patient encounters per rheumatologist decreased over time. Our findings provide novel information for rheumatology workforce planning. Factors affecting clinical activity warrant further research.

Next
Back to top

In this issue

The Journal of Rheumatology
Vol. 52, Issue 5
1 May 2025
  • Table of Contents
  • Table of Contents (PDF)
  • Index by Author
  • Editorial Board (PDF)
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word about The Journal of Rheumatology.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Encounters with Rheumatologists in a Publicly-Funded Canadian Healthcare System: A Population-Based Study
(Your Name) has forwarded a page to you from The Journal of Rheumatology
(Your Name) thought you would like to see this page from the The Journal of Rheumatology web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Accepted manuscript
Encounters with Rheumatologists in a Publicly-Funded Canadian Healthcare System: A Population-Based Study
Jessica Widdifield, Sasha Bernatsky, Janet E. Pope, Vandana Ahluwalia, Claire E.H. Barber, Lihi Eder, Bindee Kuriya, Vicki Ling, J. Michael Paterson, Carter Thorne
The Journal of Rheumatology Jun 2019, jrheum.190034; DOI: 10.3899/jrheum.190034

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

 Request Permissions

Share
Accepted manuscript
Encounters with Rheumatologists in a Publicly-Funded Canadian Healthcare System: A Population-Based Study
Jessica Widdifield, Sasha Bernatsky, Janet E. Pope, Vandana Ahluwalia, Claire E.H. Barber, Lihi Eder, Bindee Kuriya, Vicki Ling, J. Michael Paterson, Carter Thorne
The Journal of Rheumatology Jun 2019, jrheum.190034; DOI: 10.3899/jrheum.190034
del.icio.us logo Twitter logo Facebook logo  logo Mendeley logo
  • Tweet Widget
  •  logo
Bookmark this article

Jump to section

  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • References
  • PDF

Related Articles

Cited By...

Similar Articles

Content

  • First Release
  • Current
  • Archives
  • Collections
  • Audiovisual Rheum
  • COVID-19 and Rheumatology

Resources

  • Guide for Authors
  • Submit Manuscript
  • Author Payment
  • Reviewers
  • Advertisers
  • Classified Ads
  • Reprints and Translations
  • Permissions
  • Meetings
  • FAQ
  • Policies

Subscribers

  • Subscription Information
  • Purchase Subscription
  • Your Account
  • Terms and Conditions

More

  • About Us
  • Contact Us
  • My Alerts
  • My Folders
  • Privacy/GDPR Policy
  • RSS Feeds
The Journal of Rheumatology
The content of this site is intended for health care professionals.
Copyright © 2025 by The Journal of Rheumatology Publishing Co. Ltd.
Print ISSN: 0315-162X; Online ISSN: 1499-2752
Powered by HighWire