Interventional pulmonology has evolved to become mainstream practice of pulmonary medicine. In Canada, how many pulmonary physicians perform invasive pulmonary procedures or what procedures are performed, is not known. We conducted a mail survey to study the practice profile of Canadian pulmonologists with respect to performance of interventional procedures (IP).
A questionnaire consisting of 19 questions was designed to study the demographic profile, practice pattern and performance of interventional procedures by pulmonary specialists in Canada. The questionnaire was mailed to 621 pulmonary specialists listed on the Royal College of Physicians and Surgeons’ registry, ACCP membership directory and Canadian Medical Directory. A second mailing was sent out 2 months later.
A total of 355 (62%) physicians returned the completed survey. The survey indicated that 87% of the pulmonologists perform at least one interventional procedure. Flexible bronchoscopy is performed by 87%, transbronchial forceps biopsy by 80%, and transbronchial needle biopsy by 43%. Other procedures such as rigid bronchoscopy (16%), transthoracic needle biopsy (18%), laser or stents (5.7%) and medical thoracoscopy (8%) were infrequently performed. The physicians who perform IP are younger (61 vs 42%), male (86 vs 62%), have been in practice for less than 30 years (95 vs 69%), and practice in larger cities (73 vs 60%). Most physicians received training during the fellowship programs (85 vs 60%).CONCLUSIONS: In Canada, a majority of pulmonary specialists perform fiberoptic bronchoscopy and transbronchial biopsies; and a smaller number do transbronchial needle biopsies. Practice of rigid bronchoscopy, laser/stents or medical thoracoscopy has not become popular in Canada yet. The physicians who perform invasive procedures are younger, practice in larger academic centres and spend a majority of their time in clinical practice. These physicians acquired competency to perform invasive procedures primarily through the fellowship training programs.
In order to improve the practice of interventional pulmonology and specifically the newer procedures, Canadian fellowship programs must incorporate training in interventional pulmonology as part of the core curriculum.
N. Marten, None.