PEDIATRIC RHEUMATOLOGY IN ADULT RHEUMATOLOGY PRACTICES IN WASHINGTON-STATE

Objective. To determine both the extent to which adult rheumatologists treat children and their level of comfort in doing so. Methods. A que stionnaire was sent to all 77 physicians in the state of Washington wh o were listed as adult rheumatologists in the American College of Rheu matology (ACR) directory. Results. Sixty-six questionnaires (86%) were returned; 50 were identified as being from private-practicing adult r heumatologists and were the focus of this study. Sixty-two percent of the respondents reported that they care for children; predictors inclu ded increased exposure to pediatric rheumatology during fellowship (P = 0.003), increased distance from Seattle (P = 0.001), and listing one self in the ACR directory as treating children (P = 0.03), Most respon dents reported feeling discomfort in treating children younger than 6 years of age, treating Kawasaki disease, and treating polyarteritis no dosa, but most reported feeling comfortable treating children with chr onic arthritides. Impediments to referring to a pediatric rheumatologi st included distance (median distance 35 miles), convenience for the f amily, personal preference, and experience in caring for children, Twe nty-nine percent reported difficulties referring to a pediatric rheuma tologist outside of one's managed care plan, Adult rheumatologists exp ressed interest in continuing medical education dealing with pediatric rheumatology, preferably with a lecture format in their home communit ies. Conclusion. A significant number of adult rheumatologists care fo r children, Pediatric rheumatologists should provide both educational and consultative support for these adult rheumatologist colleagues.