This is the final part of a four-part series on the 2006 Rheumatology Workforce Study. (See Part 1 on page 1 of the January 2007 issue, Part 2 on page 1 of the April 2007 issue, and Part 3 on page 1 of the August 2007 issue.)
The small pediatric rheumatology subspecialty is growing, although demand is likely to increase faster than supply, according to the results of the Rheumatology Workforce Study commissioned by the ACR in 2006. However, a variety of efforts to support fellows interested in this field both during training and early in their careers offer rays of hope for the future. For example, the number of pediatric rheumatology fellowships is steadily increasing and both pediatric and adult rheumatologists are taking bold steps to change the practice model and become mentors for medical students.
“Exposure of the field is a major issue for pediatric rheumatology,” says Marisa Klein-Gitelman, MD, a pediatric rheumatologist in the division of pediatric immunology-rheumatology at Children’s Memorial Hospital and assistant professor at Northwestern University in Chicago. “We hope that by taking steps to let rising medical students know about this field and to lessen the clinical burden for those who do choose to become pediatric rheumatologists, we will recharge the workforce over the next few years,” she says. Dr. Klein-Gitelman served as a member of the ACR Workforce Study Advisory Group in 2005–2006. She adds that continuing efforts by the pediatric rheumatology executive committees at both the ACR and the American Academy of Pediatrics (AAP) are aimed at spreading this message.
One new idea to bolster the pediatric rheumatology workforce is a practice model in Arizona, which resulted in bringing a pediatric rheumatologist to the state for the first time. Other initiatives include a plan by a group of pediatric rheumatologists to do multicenter research in the United States and Canada, visiting professor programs, sponsoring residents to attend professional meetings, and increasing the number of fellowships and mentors for those who choose this specialty.
The ACR’s analysis shows that the supply and demand for the subspecialty will run in parallel during the next 20 years. Projected increases in demand stem from increases in the overall population as well as in real personal income per capita that enables consumers to purchase a greater level of healthcare services. The overall population of the United States is expected to rise in the next two decades with definitive increases in the population under age 18. The study predicts that the baseline demand for pediatric rheumatologists will rise to 287 in 2025. Meanwhile, the supply will increase to only 254 in 2025, too little to meet the demand at that time.