‘If a [GSR] member has a challenging patient scenario or health policy concern, they know they can receive guidance & input from their GSR colleagues.’ —Dr. Machua
Sung Sam Lim, MD, MPH, clinical director of rheumatology for Grady Health System, has also conducted research on racial disparities in lupus. Last year, Dr. Lim and his colleagues released research showing lupus health data from two counties in Georgia. Their work found that African American women with lupus are disproportionately impacted by the disease and experience more rapid progression and worse outcomes than other races.3
Telemedicine could potentially expand to other parts of Georgia, because the state’s telemedicine law went into effect this past January. SB 118 was passed as a direct effort to increase the prevalence of telemedicine and requires insurance companies to cover telemedicine services.
Addressing the Looming Physician Shortage
With many rheumatologists in Georgia approaching retirement age, Dr. Machua says a physician shortage, especially in rural areas, is a concern. Last year, the ACR reported 31% of Georgia’s rheumatologists are approaching retirement age.2
Dr. Machua says the rheumatology fellowship program at Augusta University and other programs that have increased fellowship positions are one way the state is hoping to increase the number of future rheumatologists. In addition, the Augusta University Medical College of Georgia announced in 2019 its “three plus three plus six” program, which—beginning in 2021—will offer medical students free tuition or loan forgiveness if they commit to medical school for three years, residency in the state of Georgia for three years and then practice in rural Georgia for six years. More rheumatologists are also needed to care for Georgia’s aging patient population. By 2030, the U.S. Census Bureau estimates more than 20% of Georgia’s residents will be 60 or older.4
The GSR’s annual meeting, originally slated for June 5–7 at the Ritz-Carlton, was moved to an online format given the COVID-19 pandemic. Speakers included Alan Baer, MD, founder and director of the Jerome L. Greene Sjögren’s Syndrome Center in the rheumatology division at Johns Hopkins Medicine, Baltimore; Adam Brown, MD, a rheumatologist with the Cleveland Clinic; Jeffrey Curtis, MD, a professor of medicine in the division of clinical immunology and rheumatology at the University of Alabama, Birmingham; and Catherine Najem, MD, a staff rheumatologist and assistant professor of medicine at Temple University’s Lewis Katz School of Medicine and director of Temple’s Vasculitis Clinic, Philadelphia.
Supporting Independent Rheumatology Practices
John A. Goldman, MD, a retired rheumatologist in Atlanta, has been a member of the GSR since its inception. One of his concerns is the difficulty private rheumatology practices are having staying afloat.
Dr. Goldman notes the Centers for Medicare & Medicaid Services (CMS) has cut reimbursement rates for dual-energy X-ray absorptiometry (DXA) in the private practice setting. “The Medicare reimbursement rate for many rheumatologists is $37,” Dr. Goldman says.
The GSR is one of many organizations that has supported S. 283: Increasing Access to Osteoporosis Testing for Medicare Beneficiaries Act of 2019, legislation that would preserve access to DXA testing and establish national minimum payments for such services. The bill was introduced last year in the U.S. Senate by Rep. Susan Collins (R-Maine).