In 2008, a rheumatology workforce analysis report published by the American College of Rheumatology Workforce Study Advisory Group concluded:
Based on assessment of supply and demand under current scenarios, the demand for rheumatologists is expected to exceed supply in the coming decades. Strategies for the profession to adapt to this changing health care landscape include increasing the number of fellows each year, utilizing physician assistants and nurse practitioners in greater numbers, and improving practice efficiency.
Fast forward to 2015
The 2015 ACR/ARHP Workforce Study of Rheumatology Specialists in the United States projects a shortage of 3,845 rheumatologists in the U.S. by 2025, an increase from the 2005 ACR Workforce Study, which projected a shortage of 2,576 rheumatologists. Reasons for the shortage include:
- An increase in baby boomer retirements (among both patients and rheumatologists).
- An increased in the prevalence of doctor-diagnosed arthritis in the next 20–25 years.
- Rheumatology fellowships attract an estimated 53% of international medical school graduates, 17% of whom plan to work abroad.
- A gender shift in the rheumatology workforce towards women. Millennial women are projected to make up 59% of the rheumatology workforce by 2030. According to the 2015 State Physician Workforce Data Book published by the Centers for Workforce Studies, women physicians tend to work seven fewer hours every week and on average treat 30% fewer patients than their male counterparts.
- Competing salaries of other medical specialties.
The report further stated that by 2030, an estimated 67 million adults (25% of the projected total adult population) aged 18 years and older will have doctor-diagnosed arthritis. This aging population is expected to increase the number of adults living with osteoarthritis, and other age-related conditions will contribute to an increased demand for rheumatologists over the coming decades.
The rheumatologist shortage will affect rheumatologists’ ability to provide adequate access to, and reduce barriers to, care for rheumatology patients. Increasing the use of nurse practitioners and physician assistants in the management of common musculoskeletal conditions in clinical practice may lessen the burden on the current workforce. To attract prospective rheumatologists, policy makers and education institutions can offer incentives, such as loan repayment programs, and increase recruitment in medical school and residency. The common goal is to provide quality care across all regions and to utilize novel healthcare strategies, such as telehealth and social media, that will benefit patients.
Together, patients, healthcare professionals, educators, and policy makers can ensure the future of rheumatology is sustainable. As part of the “CRA Interview Series 2017 – Facebook Live #CRArthritis Speaker’s Corner” event at the CRA Annual Scientific Meeting & AHPA Annual Meeting in Ottawa earlier this month, we asked guests to recount their career accomplishments and what their thoughts are about the past and future of rheumatology. Below are some interviews of interest:
Interview 4 – Cheryl Koehn from Arthritis Consumer Experts interviews Leslie Soever, President of the Arthritis Health Professions Association (AHPA – https://www.ahpa.ca), about her role in the AHPA.
Interview 5 – Cheryl Koehn from Arthritis Consumer Experts interviews Kelsey Chomistek (https://www.chronicallykelsey.com) on juvenile idiopathic arthritis advocacy and the road to becoming a rheumatologist.
Interview 13 – Linda Wilhelm from the Canadian Arthritis Patient Alliance interviews Dr. Jacques Brown from the University of Laval (https://www.ulaval.ca/en/) and a practicing rheumatologist for 34 years, about advances in rheumatology.
Interview 16 – Katie LeBlanc interviews Victoria YY Xu, first year resident in the internal medicine program at the University of Toronto (https://www.utoronto.ca), about a mysterious case she encountered on psoriatic arthritis.
Interview 20 – Anita Chan from Arthritis Consumer Experts interviews Dr. Tom Appleton, rheumatologist from St. Joseph’s Health Care London (https://www.sjhc.london.on.ca) and clinician scientist from Western University (http://www.uwo.ca), about a career in rheumatology and osteoarthritis care.