‘Looming’ shortage of rheumatologists predicted in the USA
medwireNews: Results of two modeling studies suggest that the growing demand for rheumatologists in the USA will exceed the projected increase in workforce over the next decade.
In the first study, published in Arthritis & Rheumatology, Marcy Bolster (Massachusetts General Hospital, Boston, USA) and colleagues used primary data from surveys of ACR/ARHP members and trainee rheumatologists, as well as secondary data from sources including published studies and the ACR membership database, to develop a model of the current and future rheumatology workforce.
In 2015, 431 of 468 graduate medical education (GME) adult rheumatology training positions were filled. Accounting for factors including an increasing proportion of female rheumatologists and part-time workers, and people’s intention to practice outside the USA, the model predicted that 107 full-time equivalent (FTE) positions would be taken up every year from 2015 to 2030, a significantly lower number than the 215 possible new entrants each year.
The team also identified a “maldistribution” in rheumatology training programs across the country, with “many more” programs in the Northeast and Mid-Atlantic regions compared with other areas.
In the second study, Daniel Battafarano (Uniformed Services University of the Health Sciences, San Antonio, Texas, USA) and fellow researchers used a similar approach to model supply of and demand for adult rheumatology care over the same period.
As reported in Arthritis Care & Research, the workforce in 2015 – consisting of physicians, nurse practitioners, and physician assistants – was estimated to consist of 6013 people or 5415 FTE positions. The estimated demand exceeded supply by 12.9%.
By 2030, however, the researchers projected that demand would exceed supply by 102.0%, with the number of rheumatology healthcare professionals predicted to decrease to 4882 people or 4051 FTE positions, a 25.2% decrease from 2015.
“These results represent a dramatic decline in the rheumatology workforce from 2015 to 2030,” say Battafarano and colleagues.
“The projected shortage of adult rheumatologists and the significant patient demand for rheumatologists will require innovative and multifaceted strategies to effectively provide rheumatology care,” they add.
Discussing possible ways to address this “looming supply-demand chasm,” Bolster and team believe that “increasing GME positions in rheumatology and incentivizing new entrants to practice in underserved locations are requisite.”
They call for “innovative mechanisms for GME funding to increase fellowship training positions,” as well as loan repayment programs and novel recruitment methods.
And Battafarano and team believe that strategies including greater recruitment of non-physician caregivers and expansion of telemedicine programs “may be considered to address some of these workforce challenges.”
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