BRIEF REPORT THE IMPACT OF A NEW RHEUMATOLOGIST ON THE MANAGEMENT OF RHEUMATIC DISEASE PATIENTS IN COMMUNITY HOSPITALS

Although only a small portion of patients with rheumatic diseases receive their care from rheumatol-ogists (l) , it has been estimated that a surplus of rheumatologists will exist by 1990 (2). The vast major-ity of care, however, will continue to be given by primary care providers who may or may not be properly trained to manage this specific patient popu-lation. A recent survey of rheumatology education in medical schools demonstrated that 13 % of schools did not have a full time rheumatologist and another 38% had fewer than 3 full time rheumatologists. A course on musculoskeletal examination is offered in fewer than two-thirds of medical schools. Inpatient rheuma-tology units are used for teaching in 7%, and less than 15 % of medical students participate in clinical elec-tives in rheumatology (3). Therefore, most medical students have little chance to interview and examine patients with common musculoskeletal complaints, although these skills are considered by participating physicians to be the most important training objectives (4). Many of these skills may be obtained durin