Rheumatology Workforce for the 21st Century

Mr. White underscored that a referral to a PT is not just for patients with major functional limitations. It’s also appropriate for patients who just want to manage their disease better from a physical standpoint.

He emphasized the need for innovations in the field, citing telehealth as one increasing tool that allows for easier access to patients in rural areas or when transportation is difficult, as well as integrated care in which a PT is part of a multidisciplinary team. For a model of the latter, he referred to a 2016 study illustrating a flow chart of integrating a PT in rheumatology care.⁴

3. Social workers are the linchpin of integrated care.

Jillian Rose-Smith

Jillian Rose-Smith, PhD, MPH, LCSW, vice president and chief health equity officer at Hospital for the Hospital for Special Surgery, New York, made a compelling case for the need for a social worker for all patients with rheumatic diseases beginning at the time of a diagnosis. Emphasizing the importance of a multidisciplinary approach to rheumatology care advocated by both the ACR and EULAR, she cited the many roles social workers play in bridging the gaps in care that are critical to ensure an optimal delivery of care by addressing the physical, social, emotional and spiritual needs of a patient. She noted the need to ask patients the right questions, and not just make assumptions based on eyeballing a patient.

Example: A woman was prescribed a biologic that was shipped to her home in Manhattan, but follow-up lab work indicated that that patient wasn’t taking the biologic. The woman worked and always came to her clinical appointments dressed like a corporate executive. Through a social worker assessment, it turned out the woman had lost her housing, was couch surfing and did not have access to the biologic. An easy solution: The social worker had the biologic sent to the hospital for the woman to receive the treatment. Ms. Rose-Smith emphasized that by simply asking the right questions and identifying problems, easy solutions are often available that help patients and reduce waste in the healthcare system.

Ms. Rose-Smith made a strong argument for including a social worker in a team-based approach to rheumatic care, emphasizing that optimal care requires a deep understanding of what is important to a patient and the factors that may impede delivery of and adherence to treatment.