With more than 100 members, including rheumatologists, physician assistants (PAs) and nurse practitioners (NPs), the North Carolina Rheumatology Association (NCRA) is a dynamic, member-owned organization.
Like other states, North Carolina has a shortage of rheumatologists, particularly in the state’s rural areas. “When you get outside big cities, such as Charlotte and Raleigh, patients have limited access to rheumatology care,” says Kyle Harner, MD, current NCRA president and rheumatologist with the Carolina Arthritis Center, Greenville. “They often have to wait several months to secure an appointment with a rheumatologist and then drive a long distance to receive care.”
The NCRA believes in taking a proactive approach to increasing the number of rheumatology providers in the state, Dr. Harner says. To accomplish this, the NCRA supports local fellowship programs and encourages young rheumatologists to establish practices in the state, particularly in underserved rural areas.
Rachel Wolfe, MD, a rheumatologist at Wake Forest Baptist Health, Winston-Salem, and an assistant professor of rheumatology and immunology and director of the Rheumatology Fellowship Program at Wake Forest School of Medicine, praises the NCRA for their ongoing validation of fellowship trainees.
“The association covers the cost of fellows to attend the annual NCRA conference and also supports fellowships in North Carolina throughout the academic year,” says Dr. Wolfe, who serves as the NCRA’s academic representative. “The fiscal support [the society] gives each fellowship allows us to better prepare our fellows and foster a rheumatology community here in the Carolinas.”
To help fill the need for rheumatology professionals, Dr. Harner says many rheumatology offices, including his own, are also adding NPs and PAs to their staff. “For PAs and NPs who are new to the rheumatology profession, there’s a training period required to integrate them into the practice, but it’s well worth it,” Dr. Harner says.
Telehealth can also help bridge access to care. Many rheumatologists in North Carolina began using telehealth services during the pandemic, and Dr. Harner expects this trend to continue.
Some insurers, including Blue Cross/Blue Shield of North Carolina, have said they will continue to reimburse for telehealth visits as they do for in-person visits through the end of 2021.¹ In addition, states are continuing to refine their telemedicine reimbursement policies with regard to Medicaid and private payer laws. The National Conference of State Legislators offers an interactive map illustrating each state’s current telehealth policies.