Beyond the Rheumatologist: Interprofessional Alliances Are Crucial to Rheumatic Care

SAN DIEGO—In a session at ACR Convergence 2023, experts addressed the importance of the interprofessional team in caring for rheumatology patients.

Professionals vs. Patient Needs

In 2012, researchers examined the issues rheumatology professionals tended to address for their patients and what issues patients said they wanted addressed.¹ Kim Steinbarger, PT, MHS, DHSc, assistant professor of physical therapy at Husson University, Bangor, ME, noted a divergence between the professionals and patients.

Dr. Steinbarger

The professionals favored addressing such issues as swollen joints, labs and global assessments. “We love numbers,” Dr. Steinbarger said.

Meanwhile, patients said they wanted the rheumatology professionals to address their fatigue, emotional distress and ability to self-manage their lives.¹

On any given day, a person with a rheumatic disease may experience pain, may not feel like socializing and may struggle with diet, Dr. Steinbarger noted. “Who’s going to address all that?” she asked. “Why aren’t we meeting all these needs for our patients?”

This divergence is not a matter of rheumatology professionals not wanting to care for patients or a matter of competence. Four main barriers stand in the way of meeting such needs, according to Dr. Steinbarger: 1) workforce shortages, 2) inadequate networks, 3) the knowledge of others’ roles and 4) reimbursement—although she noted that reimbursement can be overused as an excuse. Ways around these barriers do exist.

Deference to Expertise

Dr. Steinbarger suggested that rheumatology professionals tap their communities for rehabilitation professionals, pharmacists, social workers and researchers, who can help track patient outcomes. Rheumatologists and rheumatology professionals need to know the roles of healthcare professionals in other fields and follow the principle of deference to expertise—in which the discipline that is most suited to the patient’s needs in that moment takes the lead in their care.

“Who can you bring onto your team?” she asked.

Rheumatologists and rheumatology professionals can hold screening events and invite local practitioners to help conduct screenings, in what is—in addition to the collaboration possibilities—a “referral opportunity for everyone,” Dr. Steinbarger said.

Interprofessional Team

The interprofessional team goes beyond the pediatrician, nurse practitioner and physician assistant. Understanding these roles is an important part of providing the best care.

Looked at in detail, this team can provide a staggering amount of assistance to patients, noted Annelle Reed, MSN, CPNP, a pediatric nurse practitioner in the Division of Pediatric Rheumatology at Children’s of Alabama, the University of Alabama, Birmingham.