Rheumatologists: Not (Nearly) Enough to Go Around

January 19, 2018

To paraphrase Winston Churchill, rarely have so few been called upon by so many.

It’s not exactly news that the number of adults and children with rheumatologic disease in the US far outflanks the number of rheumatologists available to treat them. The American College of Rheumatology’s 2015 Workforce Study took a deep dive into the rheumatology workforce, which it deemed essential to meet the challenges facing the profession and to provide adequate care for patients with rheumatic and musculoskeletal diseases.A key finding? To paraphrase Winston Churchill, rarely have so few been called upon by so many.And the ratio of patients to rheumatologists is expected to grow even more lopsided in the next couple of decades, for a variety of reasons-among them an aging population ages and rising incidence of obesity.This slideshow offers a quick overview of some recent statistics from the CDC and key findings in the ACR’s report.Â

References:

1. Barbour KE, Helmick CG, Boring M, Brady TJ. Vital Signs: Prevalence of Doctor-Diagnosed Arthritis and Arthritis-Attributable Activity Limitation - United States, 2013â2015. Morb Mortal Wkly Rep 2017;66:246â253. doi: http://dx.doi.org/10.15585/mmwr.mm6609e1.2. Hootman JM, Helmick CG, Barbour KE, et al. Updated projected prevalence of self-reported doctor-diagnosed arthritis and arthritis-attributable activity limitation among US adults, 2015-2040. Arthritis Rheumatol. 2016;68(7):1582-7. doi: 10.1002/art.39692. PubMed PMID: 27015600.

The CDC estimates that 22.7% (54.4 million) of adults have doctor-diagnosed arthritis -–ie, some form of arthritis, rheumatoid arthritis, gout, lupus, or fibromyalgia. This number is expected to grow to 78.4 million by 2040. ©Hriana/Shutterstock.com

These numbers may be conservative, since they don’t account for the current trends in obesity, which may contribute to future cases of osteoarthritis.^1,2©alphaspirit/ Shutterstock.com

The American College of Rheumatology offers estimates similar to those of the CDC. Its 2015 Workforce Study notes that as the US population ages, the prevalence of doctor-diagnosed arthritis will rise significantly in the next generation. By 2030, 67 million (25% of the projected total adult population) will be affected – up from 52.5 million adults in 2012.

The ACR’s report also offers these numbers of full time primary providers of rheumatologic care.

A significant deficit of rheumatologists... ©Darrin Henry / Shutterstock.com

The ACR reports that fewer than 15 rheumatologists practice in 4 states (North Dakota, South Dakota, Vermont, and Wyoming). In Alaska and New Mexico, there are no board-certified practicing pediatric rheumatologists. ©Pat Ager /Shutterstock.com

Wait times for appointments with new and established patients are often long....sometimes weeks. Specifically: The ACR’s workforce survey showed these average wait times to see new adult patients:
. 15-30 days: 24%
. 31-60 days: 25%
. 61-90 days: 15%

And these average wait times to see new pediatric patients:
. 15-30 days: 25%
. 31-60 days: 14%
. 61-90 days: 7%

By 2030, fewer than 4000 physicians are expected to be in the rheumatology workforce. The same trend is true for pediatric rheumatologists – 261 is the number projected by 2030. ©Thomas Marquez / Shutterstock.com