Spring 2022 (Volume 32, Number 1)

Survey Results:
Reflections on Rheumatology

Download PDF

In light of the CRA’s milestone 75th anniversary, this issue’s survey asked our members for their personal reflections on rheumatology.

The first question respondents were asked was “Why is rheumatology important to you?” Many of the responses mentioned meaningful patient connections combined with stimulating medicine.

One respondent wrote, “It provided me with a stimulating career in an evolving and close-knit specialty, and the opportunity to work longitudinally with patients to improve their lives. The rheumatology sphere in Canada is collegial, supportive, and welcoming.”

Another said, “The humble lens under which rheumatology sees the world is inclusive, broad, respectful and mindful of all the contributing cogs and wheels within the human body, unparalleled in any other specialty.”

And another commented, “It is an art and a science; it is absolutely fulfilling in that we see the results of our therapeutic efforts in great outcomes for our patients.”

This question was followed by “What is the biggest breakthrough in rheumatology you have experienced first-hand?”

Responses included the following:

• The advent of biologics (mentioned in several responses)
• Treat-to-target approach in rheumatoid arthritis (RA)
• Improved description of phenotypes of myositis
• Advancements in diagnostic imaging and laboratory testing
• The development and evolution of the Canadian Rheumatology Association
• Development of agreed outcome measures
• Deconstruction of pain and its attribution

One respondent summed up the biggest breakthroughs as follows: “1) Biologics and other advanced therapies: revolutionized patient care and enhanced the appeal of rheumatology as a specialty and; 2) Treat-to-target approach in RA; Even though all our target measures are flawed, they ensure a better therapeutic strategy. This is exemplified by quotations from the eminent physicist Lord Kelvin ‘If you cannot measure it, you cannot improve it,’ and the management guru Peter Drucker ‘You can't manage what you can't measure.’”

The last question asked members, “What do you see in store for the future of rheumatology?”

Responses included the following:

• More team-based care
• Narrowing scope of rheumatology practice towards inflammatory diseases
• Improved pathways to care for patients
• Increased use of virtual and asynchronous care where appropriate
• Precision medicine
• Personalization of care and customization of treatment regimens
• More rheumatologists and greater diversity
• More understanding of the conditions we treat
• Quality improvement measures to use our existing resources wisely with awareness of resource limitations
• More ultrasound use in rheumatology
• Better understanding of therapeutic targets
• Wider acceptance of models of interprofessional care to provide optimal, cost-effective outcomes/remission
• An effective treatment for osteoarthritis

As one commenter put it, “The future of rheumatology is the ruralization of rheumatology care. We need to work with nurses, physiotherapists, occupational therapists, pharmacists, and family physicians stationed in rural Canada to deliver the same excellence of care being provided in urban areas. We will need remote data gathering devices, upcoming ultrasound technologies that scan and report by artificial intelligence techniques, and all the tools telemedicine can muster to achieve this.”

The CRA would love to hear your reflections on rheumatology. For any questions and feedback on the survey, please reach out to Kevin Baijnauth at Kbaijnauth@rheum.ca.