“In my practice, we did not have a drop in volume, job loss or hours,” Dr. Snow says. “Certainly, during the beginning in the pandemic, we did have a drop and a switch to telemedicine. However, we have been able to be back to normal—or above normal—volume since last summer.”
Patient demand is very high regionally in Omaha, he adds, noting a pre-COVID-19 trend of rheumatologists retiring. In fact, he jokingly encourages rheumatologists looking to practice in Nebraska to reach out because job openings are available.
Looking more broadly at patient volume across the country, Dr. Snow believes any shortage of patients is short term. “I suspect some patients cancelled their appointments early in the pandemic and then felt they didn’t need to see rheumatology for their osteoarthritis or fibromyalgia, perhaps instead choosing to visit their primary care provider or felt better than expected off their medication,” he says.
Dr. Snow also notes a drop in patients could be the result of some patients not wanting to keep up with their visits through telemedicine during the height of the pandemic. “It’s tough to say, but I doubt any drop in patients is a long-term trend,” he says. “The shortage of rheumatologists nationally is so great, and I am not concerned about a shortage of patients.”
Reimbursement
Medicare coverage was a concern for some of the rheumatologists surveyed, of which 15% said they will stop treating at least some current patients on Medicare or may not take on new patients on Medicare. This same question regarding treating Medicare patients was asked in the Medscape Physician Compensation Report 2020, in which only 6% of rheumatologists said they would stop seeing these patients.5 This finding means there was an increase in surveyed rheumatologists who are changing or considering a change regarding accepting patients on Medicare.
Also, 68% of surveyed rheumatologists said they will participate in Centers for Medicare & Medicaid Services’ Merit-Based Incentive Payment System (MIPS) in 2021.
How Does Rheumatology Compare?
This year, rheumatologists ranked 21st in compensation compared with other medical specialties. This ranking is up slightly, with rheumatologists ranking 23rd in overall physician specialty compensation in both 2020 and 2019. The 2021 report shows rheumatologists’ annual income ranking just below that of neurologists, who reported $291,000 in annual income, and just above psychiatrists, who reported $275,000 in annual income.4
Plastic surgery and orthopedics remain the highest paid medical specialties, with plastic surgeons edging out orthopedists with a $47,000 increase from the 2020 report to top the list of physician earners at $560,000 in annual income. Pediatrics is the lowest paid physician specialty, at $221,000 for reported annual salary.3
