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An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Pediatric Rheumatologists Increasing in Number but Still Rare

Catherine Kolonko  |  Issue: July 2012  |  

Lorrie Pickrell and her daughter Makailya, age 14 years, of Ellsinore, Mo., clock more than three hours each way to get to a pediatric rheumatologist in St. Louis. If Makailya sits too long, her legs and hips hurt.

“We usually stop about halfway for her to get out….It’s an all-day thing,” says Lorrie.

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A straight-A student, Makailya dislikes missing school for doctor appointments. She was diagnosed with juvenile arthritis at age seven years, but had complications since she was four years old.

Both families joined the AF’s Advocacy Summit in Washington, D.C., in April to rally congressional support for the Pediatric Subspecialty Loan Repayment Program. The aim is to give more children greater access to pediatric rheumatologists by attracting more medical students to the subspecialty. Congress approved the program as part of the healthcare reform bill, but has not yet appropriated funds for it, says Amy Melnick, vice president of advocacy for the AF.

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This is the second year that Makailya attended the AF summit to speak to congressional leaders and meet other children her age with the same disease. She says it is important to tell legislators that more pediatric rheumatologists are needed so that children like her don’t go undiagnosed.

“The day that they finally diagnosed me, I couldn’t walk,” says Makailya. “If they had got me in sooner, I probably wouldn’t be as bad as I am.”

“We contact residency program directors, and anybody who might be interested in pediatric rheumatology has the opportunity to apply for a slot, and there are 25 slots,” says Dr. Klein-Gitelman. “We bring these pediatric residents to the annual meeting. They get to meet fellows and faculty in pediatric rheumatology and have opportunities to interact with them and ask questions, as well as participate in the meeting.”

Every medical problem and every drug you use and every treatment plan you set up has to be considered in light of where the patient is in terms of their growth and development, and that’s constantly changing because it’s such a dynamic process.

—Emily von Scheven, MD

Since it began in 2001, the Pediatric Residents Program has sent 240 residents to ACR annual meetings. Of the participants that completed their residency, 79 applied and were accepted into a pediatric rheumatology fellowship program. The ACR Research and Education Foundation (REF) also funds a visiting professor program that pairs pediatric rheumatologists with academic centers with no pediatric rheumatology training program so they can spend time speaking to medical students, residents and fellows across the country about the subspecialty. The REF also provides funding opportunities for these students to participate in mentored clinical and research experiences within rheumatology. Physicians like Drs. von Scheven and Klein-Gitelman who have participated in the ACR and REF recruitment efforts say they enjoy the holistic aspect of rheumatology and the impact that child development plays in treatment.

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