Practice patterns of respirologists in Canada.
The demographics and practice patterns of respirologists in Canada have not been studied. To evaluate the demographic characteristics of respirologists in practice, appraise current respirology manpower and ascertain the utilization of invasive diagnostic and therapeutic procedures (interventional pulmonology), a mail survey of all Canadian respirologists was conducted. The questionnaires were completed by 62% (n=355) of 573 possible participants. Of the respirologists who responded, 69.2% were younger than 50 years of age, 70.3% had been in practice for fewer than 20 years, 64.4% were in full- or part-time academic practice, and 72.9% were based in urban centres with a catchment population of more than 250,000. The current ratio of respirologists to population in Canada, assuming a total population of 31,000,000, is 1:54,101. In the present survey, only 68.3% respirologists practised clinical respirology for 50% or more of their time, and half (49.5%) of respirologists devoted more than 50% of their time on nonrespirology or nonclinical activities. Thus, the more precise respirologist to population ratio appears to be 1:81,000. The current ratio meets the Royal College of Physicians and Surgeons of Canada recommendations, and the current training programs meet present manpower requirements. With respect to the procedures performed, most specialists carried out bedside procedures and flexible bronchoscopy; a much smaller number did invasive procedures such as rigid bronchoscopy (20.8%), transbronchial needle biopsy of lung (43%), transbronchial biopsy of mediastinal lymph nodes (38%), therapeutic bronchoscopy using laser, cryotherapy and stents (8.7%), transthoracic needle biopsy (22.2%) and thoracoscopy (11.3%). Because 97% of pulmonary specialists would like to perform invasive procedures, fellowship programs, mini-residencies and practical courses should provide the necessary training.
Sharma
Sat
S
Section of Respirology, Department of Internal Medicine, University of Manitoba, St Boniface general Hospital, BG034-409 Tache Avenue, Winnipeg, Manitoba R2H 2A6, Canada. ssharma@sbgh.mb.ca
Dhar
Anil
A
McLean
Laura
L
Sahni
Perry
P
Lertzman
Morley
M
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D001707:Biopsy, Needle; D001999:Bronchoscopy / Q000706:statistics & numerical data; D002170:Canada; D002983:Clinical Competence; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D015272:Pulmonary Medicine / Q000592:standards* / Q000639:trends; D012140:Respiratory Tract Diseases / Q000175:diagnosis* / Q000628:therapy*; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013906:Thoracoscopy / Q000706:statistics & numerical data