Implications & Solutions
The effect of not having enough pediatric providers is that children with rheumatic disease may not get the quality of care they need when they need it. The situation also causes a strain on existing providers, who don’t have time to see all of the patients.
“Certainly we know that some children, especially children that are far from pediatric centers, are treated by adult rheumatologists. And that’s great … but I think it’s important to have more pediatric specialists,” Dr. Correll says. “Children are different in many ways than adults, and so things we have to think about with children are their growing skeleton, their development, and particularly some diseases in rheumatology are more pediatric focused. … You really just want the expert for children with these diseases to be providing that specialty care as much as possible—or at least a partnership of pediatric rheumatology providers with adult providers.”
Attracting new providers to the field is key to addressing the current and future workforce issues. One way to do this is to encourage medical students and residents who show interest by sharing additional information with them. For example, the ACR and the Childhood Arthritis and Rheumatology Research Alliance have residency programs that provide helpful information, Dr. Correll says.
To help attract providers, Dr. Correll and her co-authors suggest considering a two-year clinical fellowship for physicians seeking to work in community practice or creating strictly clinical positions within academic institutions, recruiting and training more PAs and NPs, and offering financial incentives like medical student loan debt relief and loan repayment programs. Other methods cited in the study include promoting changes in the geographical distribution of providers, improving quality of care initiatives in primary care and extending the use of telemedicine.
Telemedicine, which has become much more mainstream during the COVID-19 pandemic, can help address the issue of geography post-pandemic as well. Although it won’t increase the number of appointments a physician can fit into a day, virtual appointments can help triage new patients, save time spent driving for both patients and providers and facilitate access to specialists for patients in rural areas.
With these workforce issues identified, rheumatology professionals can work together to implement solutions; doing so creates hope that the current trajectory can be corrected.
“The ACR president has made workforce solutions one of his priorities in 2021, which is really great,” Dr. Correll says. “I am part of a small group that has been [asked] to recommend potential strategies to the ACR for workforce solutions. I am hopeful the ACR can facilitate thoughtful solutions. … It’s a strain on the provider when we don’t have enough of a workforce, it’s a strain on the patients, and I think we all want to make improvements that will help everybody.”
