Rheumatology Workforce for the 21st Century

The roles of advanced practice providers, social workers & physical therapists

WASHINGTON, D.C.—The effective management of patients with rheumatic diseases requires a multi-disciplinary, team-based approach that draws on the expertise of a range of healthcare professionals addressing the often-complex issues surrounding systemic and autoimmune conditions. Advanced practice providers, physical therapists (PTs) and social workers all play an important role in this team-based approach, each bringing unique expertise to ensuring optimal care is delivered to and acted on by the patient.

In a session on the state of interprofessional care in rheumatology, speakers described the current and potential roles of advanced practice providers, PTs and social workers in the care of patients with rheumatic illnesses. Patient education stood out as a key way for all three of these professional groups to contribute to the care of patients with rheumatic conditions, albeit with different hues that augment the role of rheumatologists.

Advanced practice providers ranked patient education as their top responsibility, followed by medication dose adjustments and conducting physical exams. For PTs, patient education is an essential component of helping patients with pain and functional limitations around their disease. For social workers, patient education is critically linked to understanding holistically all the factors that guide and may undermine a patient’s ability or willingness to engage in treatment and receive optimal care.

The session brought into sharper focus the needs of patients with rheumatic diseases that require a team-based approach, including the incorporation of more advanced practice providers as the rheumatology workforce shrinks, the inclusion of PTs to support and improve daily functioning and the reliance on social workers as the linchpin that holds the team together by ensuring, for example, that a proposed treatment can actually be delivered to and adhered to by a patient given the social determinants of health that govern their life.

Key Takeaways

1. The number of APPs is growing, & their role is expanding.

Leila Khalili

The role of advanced practice providers, mainly nurse practitioners (NPs) and physician assistants (PAs), continues to grow in rheumatology. Leila Khalili, NP-C, director of research operations, Lupus Center, Columbia University Irving Medical Cancer Center, New York, highlighted data from the 2015 adult rheumatology workforce study showing that the numbers of NPs and PAs are projected to increase by 40.4% and 45.3%, respectively, by 2030; meanwhile the number of adult rheumatologists is projected to decrease by 30.9%.¹