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The Happiest Specialty: Rheumatology Is #1!

James R. O’Dell, MD  |  Issue: July 2012  |  July 10, 2012

Dr. O'Dell

Dr. O’Dell

A recent Medscape poll of more than 292,000 physicians determined that rheumatologists were the happiest subspecialists! This, of course, was no surprise to many of us, unless you have been on the advocacy listserv lately. If we are so happy, then why are we not attracting more bright young people to replace all of us old guys and, to a lesser extent, gals (the mean age of rheumatologists is currently 57)? How can we get the word out about this apparently well-kept secret? Obviously, with a measly 2.8% of internal medicine residents electing to go into rheumatology and a projected shortage of 2,600 rheumatologists by 2025, we are not doing a very good job spreading the news (see Figure 1).

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Figure 1: Base Case: Adult Rheumatologists, 2005-2025 Supply and Demand: Adult Baseline Demand increase is attributed to: 40% population growth holding the age distribution constant, 11% population aging, and 49% per capita income growth.

How can we make sure the next generation knows that happiness is the most important thing and that it is not all about money? The median salary for a rheumatologist is $224,000, while the median salary of a gastroenterologist is almost double that. Rheumatologists were the happiest, while GI docs were tied with neurologists for the least happy. Some would question, Why wouldn’t I want to make twice as much money? A little perspective is always enlightening—a rheumatologist’s income is over five times the median income of U.S. households and over 10 times the poverty line for a family of four. Having the opportunity to know many rheumatologists around the country, I have not met any who are starving. Even if we doubled our income, half of it would go to some form of tax anyway.

In addition to reflecting on the question of what makes us happy, I have done an informal poll over the last several months. At the many dinners I get to share with rheumatologists (there are a few photos from those meals at the bottom of the page—don’t we look like we’re having fun?), I have asked, Why are we #1? Before I get any e-mails from you statisticians out there about the unscientific nature of either the Medscape survey or my even more unscientific dinner conversations, I get it. I fully realize that my dinner conversations are biased in several important ways. People at these dinners have first elected to be rheumatologists and, for the most part, have elected to get involved with the ACR. Yes, almost all the dinners I have recently attended involve some sort of ACR volunteers. Nevertheless, the answers I have received have been enlightening and largely consistent across many dinners.

The Constitution only guarantees the American people the right to pursue happiness. You have to catch it yourself.

—Attributed to Benjamin Franklin.

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