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Shortage of Practicing Rheumatologists in the U.S.

Closest doctor may be 100 to 200 miles away (November 27)

A study published in Arthritis & Rheumatism shows that smaller micropolitan areas of the U.S.—those with fewer than 50,000 people—have very few or no practicing rheumatologists who treat adults. In some of these areas, individuals have to travel more than 200 miles to reach the closest specialist.

In 2005, there were roughly 1.7 adult rheumatologists per 100,000 persons. However, with the aging U.S. population and lack of growth in the number of rheumatologists, experts projected that by 2010, there would be a shortage of 400 rheumatologists and that the number would climb to 2,500 by 2025.

Led by Dr. John FitzGerald from the University of California at Los Angeles, researchers analyzed the distribution of rheumatology practices in the U.S. using the American College of Rheumatology (ACR) membership database. In 2010, there were 3,920 practicing rheumatologists in the ACR database; 90% practiced in metropolitan regions, 3% in micropolitan areas, and 7% in rural areas.

In regions with fewer than 50,000 people, there was limited access to a practicing rheumatologist, with the nearest practice in 50 of the 479 micropolitan areas often more than 100 miles away. In some regions with populations of 200,000 or more, there were no practicing rheumatologists in the area. Researchers reported a higher concentration of rheumatology practices in more populous areas characterized by higher median incomes.

The study authors emphasize that interventions are needed to increase the supply of rheumatologists to underserved regions. They suggest that the ACR commit to providing updated data on supply of rheumatologists by regions so that graduates are aware of practice opportunities; that the ACR increase funding for fellow positions in areas that lack rheumatology services; and that the roles of nurse practitioners and physician assistants be expanded where rheumatologists are in short supply.

[Source: Arthritis Rheum; November 27, 2013 (online).]