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Special Article - One of the best experts on this subject based on the ideXlab platform.
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Ultrasound in American Rheumatology practice: report of the American College of Rheumatology musculoskeletal ultrasound task force.
Arthritis care & research, 2010Co-Authors: American College Of Rheumatology Musculoskeletal Ultrasound Task Force, Special ArticleAbstract:American College of Rheumatology Musculoskeletal Ultrasound Task Force. (2010). Ultrasound in American Rheumatology practice: report of the American College of Rheumatology musculoskeletal ultrasound task force.
Marcy B Bolster - One of the best experts on this subject based on the ideXlab platform.
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Addressing the Rheumatology workforce shortage: A multifaceted approach.
Seminars in Arthritis and Rheumatism, 2020Co-Authors: Eli M. Miloslavsky, Marcy B BolsterAbstract:A significant challenge facing the field of Rheumatology is the projected gap between the growing demand for rheumatologists and the available workforce. In order to improve access to care, augmenting the Rheumatology workforce is required. Herein we discuss potential solutions to the anticipated workforce shortage, including 1) expanding the training of Rheumatology physicians; 2) increasing nurse practitioner, physician assistant and pharmacist utilization in Rheumatology practice; 3) growing the use of telemedicine; and 4) reducing burnout in order to retain practicing rheumatologists. Building on the existing literature in these areas, we propose a multifaceted approach to addressing the Rheumatology workforce shortage.
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core curriculum to facilitate the expansion of a Rheumatology practice to include nurse practitioners and physician assistants
Arthritis Care and Research, 2018Co-Authors: Benjamin J Smith, Marcy B Bolster, Barbara Slusher, Christine Stamatos, Jeanne R Scott, Heather Benham, Salahuddin Kazi, Elizabeth A Schlenk, Daniel E Schaffer, Vikas MajithiaAbstract:Objective Due to an aging population, increasing prevalence of rheumatic disease, and a growing supply and demand gap of Rheumatology providers, innovative solutions are needed to meet the needs of persons with rheumatic conditions. Nurse practitioners (NPs) and physician assistants (PAs) have been identified as a group of health professionals who could help address the workforce shortage. The Executive Committee of the Association of Rheumatology Health Professionals (ARHP), a division of the American College of Rheumatology (ACR), charged a task force to facilitate the preparation of NPs/PAs to work in a Rheumatology practice setting. Methods The task force, consisting of private practice and academic rheumatologists, and NPs and PAs, from both adult and pediatric settings, conducted a needs assessment survey of current NPs and PAs to identify mechanisms for acquiring Rheumatology knowledge. Through face-to-face and webinar meetings, and incorporating stakeholder feedback, the task force designed a Rheumatology curriculum outline to enrich the training of new NPs and PAs joining Rheumatology practice. Results Informed by the needs assessment data and stakeholders, an NP/PA Rheumatology curriculum outline was developed and endorsed by the ACR Board of Directors for use by community-based and academic Rheumatology practices, whether pediatric or adult, who desire to add NPs and PAs to their practice setting. Conclusion As Rheumatology is facing workforce shortages, the ACR/ARHP Rheumatology curriculum outline can be utilized to train NPs and PAs and create more efficient integration of NPs and PAs into Rheumatology practice.
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2015 american college of Rheumatology workforce study supply and demand projections of adult Rheumatology workforce 2015 2030
Arthritis Care and Research, 2018Co-Authors: Daniel F Battafarano, Marcy B Bolster, Marcia Ditmyer, John Fitzgerald, Chad L Deal, Ann R Bass, Rodolfo Molina, Alan R Erickson, Jonathan S HausmannAbstract:OBJECTIVE: To describe the character and composition of the 2015 US adult Rheumatology workforce, evaluate workforce trends, and project supply and demand for clinical Rheumatology care for 2015-2030. METHODS: The 2015 Workforce Study of Rheumatology Specialists in the US used primary and secondary data sources to estimate the baseline adult Rheumatology workforce and determine demographic and geographic factors relevant to workforce modeling. Supply and demand was projected through 2030, utilizing data-driven estimations regarding the proportion and clinical full-time equivalent (FTE) of academic versus nonacademic practitioners. RESULTS: The 2015 adult workforce (physicians, nurse practitioners, and physician assistants) was estimated to be 6,013 providers (5,415 clinical FTE). At baseline, the estimated demand exceeded the supply of clinical FTE by 700 (12.9%). By 2030, the supply of Rheumatology clinical providers is projected to fall to 4,882 providers, or 4,051 clinical FTE (a 25.2% decrease in supply from 2015 baseline levels). Demand in 2030 is projected to exceed supply by 4,133 clinical FTE (102%). CONCLUSION: The adult Rheumatology workforce projections reflect a major demographic and geographic shift that will significantly impact the supply of the future workforce by 2030. These shifts include baby-boomer retirements, a millennial predominance, and an increase of female and part-time providers, in parallel with an increased demand for adult Rheumatology care due to the growing and aging US population. Regional and innovative strategies will be necessary to manage access to care and reduce barriers to care for Rheumatology patients.
Vikas Majithia - One of the best experts on this subject based on the ideXlab platform.
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Rural health issues in Rheumatology: a review.
Current Opinion in Rheumatology, 2020Co-Authors: Day S. Lennep, Teresa M. Crout, Vikas MajithiaAbstract:PURPOSE OF REVIEW: Early access to Rheumatology is imperative to achieve appropriate outcomes in rheumatologic diseases. But there seems to be a significant gap and disparity in the access to Rheumatology care between urban and rural areas. This review was undertaken to analyze this issue. RECENT FINDINGS: A significant delay in diagnosis of rheumatic disorder has been correlated to the travel distance to rheumatologist. It is also clear that currently, a significant Rheumatology workforce shortage exists and is projected to worsen significantly, thereby making this gap and disparity much bigger. SUMMARY: The scope of this gap and disparity in Rheumatology care for rural patients remains incompletely defined and quantified. It is felt to be a significant issue and it is important to invest resources to obtain information about its scope. In addition, a number of solutions already exist which can be implemented using current network and infrastructure. These include relatively low-cost interventions such as patient navigator, remote Rheumatology experts and if possible tele-Rheumatology. These interventions can assist temporarily but a major improvement will require policy change at federal and state government level as well as involvement, buy-in, and incentivization of the providers and health networks providing Rheumatology care.
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core curriculum to facilitate the expansion of a Rheumatology practice to include nurse practitioners and physician assistants
Arthritis Care and Research, 2018Co-Authors: Benjamin J Smith, Marcy B Bolster, Barbara Slusher, Christine Stamatos, Jeanne R Scott, Heather Benham, Salahuddin Kazi, Elizabeth A Schlenk, Daniel E Schaffer, Vikas MajithiaAbstract:Objective Due to an aging population, increasing prevalence of rheumatic disease, and a growing supply and demand gap of Rheumatology providers, innovative solutions are needed to meet the needs of persons with rheumatic conditions. Nurse practitioners (NPs) and physician assistants (PAs) have been identified as a group of health professionals who could help address the workforce shortage. The Executive Committee of the Association of Rheumatology Health Professionals (ARHP), a division of the American College of Rheumatology (ACR), charged a task force to facilitate the preparation of NPs/PAs to work in a Rheumatology practice setting. Methods The task force, consisting of private practice and academic rheumatologists, and NPs and PAs, from both adult and pediatric settings, conducted a needs assessment survey of current NPs and PAs to identify mechanisms for acquiring Rheumatology knowledge. Through face-to-face and webinar meetings, and incorporating stakeholder feedback, the task force designed a Rheumatology curriculum outline to enrich the training of new NPs and PAs joining Rheumatology practice. Results Informed by the needs assessment data and stakeholders, an NP/PA Rheumatology curriculum outline was developed and endorsed by the ACR Board of Directors for use by community-based and academic Rheumatology practices, whether pediatric or adult, who desire to add NPs and PAs to their practice setting. Conclusion As Rheumatology is facing workforce shortages, the ACR/ARHP Rheumatology curriculum outline can be utilized to train NPs and PAs and create more efficient integration of NPs and PAs into Rheumatology practice.
James W Varni - One of the best experts on this subject based on the ideXlab platform.
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the pedsql in pediatric Rheumatology reliability validity and responsiveness of the pediatric quality of life inventory generic core scales and Rheumatology module
Arthritis & Rheumatism, 2002Co-Authors: James W Varni, Michael Seid, Tara Smith Knight, Tasha M Burwinkle, Joy Brown, Ilona S SzerAbstract:Objective The Pediatric Quality of Life Inventory (PedsQL) is a modular instrument designed to measure health-related quality of life (HRQOL) in children and adolescents ages 2–18 years. The 23-item PedsQL 4.0 Generic Core Scales are multidimensional child self-report and parent proxy-report scales developed as the generic core measure to be integrated with the PedsQL disease-specific modules. The 22-item PedsQL 3.0 Rheumatology Module was designed to measure pediatric Rheumatology–specific HRQOL. This study was undertaken to demonstrate the reliability, validity, and responsiveness of the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Rheumatology Module in pediatric Rheumatology. Methods The 4 PedsQL 4.0 Generic Core Scales (physical, emotional, social, and school functioning) and the 5 PedsQL 3.0 Rheumatology Module scales (pain and hurt, daily activities, treatment, worry, and communication) were administered to 231 children and 244 parents (271 subjects accrued overall) recruited from a pediatric Rheumatology clinic. Results Internal consistency reliability for the PedsQL Generic Core total scale score (α = 0.91 for child self report, α = 0.93 for parent proxy report), physical health summary score (α = 0.87 for child self report, α = 0.89 for parent proxy report), and psychosocial health summary score (α = 0.86 for child self report, α = 0.90 for parent proxy report) were acceptable for group comparisons. The Rheumatology Module scales also demonstrated acceptable reliability for group comparisons (α = 0.75–0.86 for child self report, α = 0.82–0.91 for parent proxy report). Validity was demonstrated using the known-groups method. The PedsQL distinguished between healthy children and children with rheumatic diseases as a group. The responsiveness of the PedsQL was demonstrated through patient change over time as a result of clinical intervention. Conclusion The results demonstrate the reliability, validity, and responsiveness of the PedsQL 4.0 Generic Core Scales and the PedsQL 3.0 Rheumatology Module in pediatric Rheumatology.
Peter Mandl - One of the best experts on this subject based on the ideXlab platform.
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OP0011 Rheumatology Training Experience – European Survey Among Rheumatology Trainees & Newly Qualified Specialists
Annals of the Rheumatic Diseases, 2015Co-Authors: Francisca Sivera, Sofia Ramiro, Nada Čikeš, Maxime Dougados, L. Gossec, T.k. Kvien, Ingrid E. Lundberg, Peter Mandl, Arumugam Moorthy, S PanchalAbstract:Objectives To describe the confidence and training experience acquired during Rheumatology training in 21 core competences across the different European countries. Methods As part of a European project to evaluate the differences and similarities in training in Rheumatology across Europe, we developed an online survey to assess the training experience. The target population was trainees in Rheumatology and rheumatologists certified in the past 5 years. We selected 21 competences, core to Rheumatology clinical practice, from the UEMS European curriculum framework (1). For each competence, respondents were asked to assess the confidence in their abilities (0-10 numerical rating scale), the existence of formal education (yes/no), the exposure to patients (0; 1-10; 11-50; 51-100; 101-150; >150) and the existence of an assessment (yes/no) where appropriate. All questions referred to the training period. The survey (June-December 2014) was disseminated in each country by a national PI. Results We gathered 1433 answers to the survey of which 1243 could be included in the analysis (28% of overall target population). Respondents came from the 41 EULAR countries with Rheumatology training (30% male, 58% trainees). A summary of the results is presented in Table 1. For any given competence, mean confidence was higher in respondents who had received formal education than in those who had not. Similarly, for all clinical competences and rheumatologic techniques, mean confidence was also higher amongst those who had a higher patient exposure during their training that in those who managed ≤10 patients with that given disease. Mean acquired confidence was also higher in respondents who had a longer training period (internal medicine plus Rheumatology) than in those with a shorter training period for all competences except osteoporosis and hand Xray interpretation. The level of confidence was also higher for specialists (vs trainees). Conclusions The acquired confidence in competences during the Rheumatology training program considered core for Rheumatology practice is variable, but overall reasonably high. Most of the trainees seem to receive formal education and have some patient exposure in all competences, though only around half are assessed in each competence. References European Board of Rheumatology (a section of UEMS). The European Rheumatology Curriculum Framework. www://dgrh.de/fileadmin/media/Praxis_Klinik/european_curriculum_uems_april_2008.pdf Disclosure of Interest None declared
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differences and similarities in Rheumatology specialty training programmes across european countries
Annals of the Rheumatic Diseases, 2015Co-Authors: Francisca Sivera, Sofia Ramiro, Ingrid E. Lundberg, Peter Mandl, Arumugam Moorthy, Nada Cikes, M Dougados, Laure Gossec, Tore K Kvien, Sonia PanchalAbstract:Objectives To analyse the similarities and discrepancies between the official Rheumatology specialty training programmes across Europe. Methods A steering committee defined the main aspects of training to be assessed. In 2013, the Rheumatology official training programmes were reviewed for each of the European League Against Rheumatism (EULAR) countries and two local physicians independently extracted data on the structure of training, included competencies and assessments performed. Analyses were descriptive. Results 41 of the 45 EULAR countries currently provide specialist training in Rheumatology; in the remaining four rheumatologists are trained abroad. 36 (88%) had a single national curriculum, one country had two national curricula and four had only local or university-specific curricula. The mean length of training programmes in Rheumatology was 45 (SD 19) months, ranging between 3 and 72 months. General internal medicine training was mandatory in 40 (98%) countries, and was performed prior to and/or during the Rheumatology training programme (mean length: 33 (19) months). 33 (80%) countries had a formal final examination. Conclusions Most European countries provide training in Rheumatology, but the length, structure, contents and assessments of these training programmes are quite heterogeneous. In order to promote excellence in standards of care and to support physicians’ mobility, a certain degree of harmonisation should be encouraged.
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Recommendations of the Austrian Society of Rheumatology/Austrian Radiology-Rheumatology Initiative for Musculoskeletal Ultrasound for the application of ultrasound in Rheumatology
Wiener klinische Wochenschrift, 2014Co-Authors: Christina Duftner, Peter Mandl, Christian Dejaco, Franz Kainberger, Klaus Machold, Thomas Nothnagl, Tobias Dezordo, Rusmir Husic, Claudia Schüller-weidekamm, Michael SchirmerAbstract:It is the current goal in Rheumatology to diagnose and treat inflammatory rheumatic diseases early in order to avoid structural damage. Functional imaging methods such as musculoskeletal sonography are increasingly used to support the clinical diagnosis. To ascertain the quality of ultrasound assessments performed by rheumatologists in Austria, the Austrian Radiology-Rheumatology Initiative for Musculoskeletal Ultrasound (ARRIMUS) proposed recommendations for a training curriculum, technical standards for ultrasound equipment, minimum requirements for documentation, indications for sonography and the use of ultrasound for interventions. These recommendations have been endorsed by the Austrian Society of Rheumatology and should aid rheumatologists to perform high quality ultrasound assessment in clinical practice.
