Who Will Treat Arthritis in 2005?

Most practicing rheumatologists are white (79%) and married (89%). Nearly half (44%) of women in practice have school-aged children. The primary practice setting is split among group practice (43%), solo or partnership practice (32%), and medical school (16%). Nearly three-quarters (74%) have an infusion unit, 64% densitometry, 55% X-ray, and 61% an on-site laboratory. A growing number (21%) of practices have early arthritis centers.

The survey found that the majority of pediatric rheumatologists were unwilling to treat a patient over age 18 (44.9%) or age 21 (33.3%). Among adult rheumatologists, 27.7% says the youngest they would want to treat a patient would be 16 to 17 years, and another 22.4% says they would be reluctant to treat a patient age 12 to 15.

Only a small percentage of practices currently employ a nurse practitioner (15.5%) or a physician’s assistant (7.2%). This finding is important since the study recommends adding these professionals to a practice as a key way to address workforce shortages.

Family status was shown to have a dramatic impact on the number of hours worked by female versus male rheumatologists. The overwhelming majority (83%) of female rheumatologists are married and of that number 26% have preschool-aged children. Married women rheumatologists report working 440 fewer hours per year and women with children under six work 660 hours less per year than their single counterparts. In contrast, married men who are rheumatologists work 330 more hours a year than single men but those with children under age 18 work 100 less hours annually.

Male and female adult and pediatric rheumatologists are all pretty satisfied with their work. Only 6% to 10% reported any level of dissatisfaction. However, the need for more colleagues in a practice is evident. More than 30% are in practices that are currently looking to hire another rheumatologist and more than half are in practices that plan to hire additional partners within the next five years. Income levels reported in the survey show that the median income for a rheumatologist is between $151,000 and $193,000. More than half (57%) of full-time rheumatologists receive an income between $100,000 and $250,000.

Walter Barr, MD

The workforce study also points to reported wait times for patients as a strong indication of excess demand. The mean wait time for a non-urgent patient is 37 days and almost half of the rheumatologists surveyed said that their non-urgent patients waited more than four weeks for an appointment. The wait time for new rheumatology patients is higher than for general medicine and other specialty referrals such as cardiology and gastroenterology. These data point to the need for practice redesign, an area of concern that the ACR is already beginning to address.

Chad Deal, MD

The ACR is confident that the 2006 Rheumatology Workforce Study will meet the needs of the profession into the future. It includes a computer modeling tool that allows for periodic reassessment of the projections made in the study. “Perhaps the real value to any workforce study is that it forces us to evaluate our profession,” says Dr. Birnbaum. “The study challenges us to consider the impact on the practice of our members and how to prepare our members to continue