High rates of satisfaction with medicine as a career (75%) and rheumatology as a profession (66%) are expressed by rheumatologists, but only 49% say they would choose the same practice setting if they could do it over again.
The Medscape survey was conducted from Feb. 2, 2011, to March 30, 2011, with a total of 15,794 responses from all specialties. Of these, 1%, or about 1,500, were rheumatologists.
Rheumatologists Respond What do rheumatologists think about this report?
“The Medscape report is sobering in many aspects, but encouraging in others,” says Abby Abelson, MD, chair of Department of Rheumatology at Cleveland Clinic and chair of the ACR Committee on Training and Workforce Issues. Noting that the report is somewhat limited by a small sample size of responders in rheumatology, she added the placement of rheumatologists at the lower end of the specialties can be “partially explained by the long visit length required in our specialty, which they documented to be over 17 minutes for over 75% of rheumatologists.”
“As we face a large increase in the numbers of patients who will need rheumatologic care in the coming decades, these data may make recruiting new physicians to our specialty challenging,” she adds. “We will need to advocate at all levels for appropriate reimbursement for the great deal of time that is required to appropriately evaluate complex patients with multi-system rheumatic diseases.”
William F. Harvey, MD, assistant professor of medicine in the division of rheumatology at Tufts Medical Center in Boston, says that, “this report is accurate in the sense that rheumatology is ranked near the bottom, but the reality is far worse. First, there are severe regional differences, with the Northeast seeing lower salaries. Second, the median age of the rheumatology workforce is 55 years old. That means that the median salary sited in the article are inflated as >50% of rheumatologists have been in practice for 25 years and thus have higher salaries.”
He adds that changing demographics also impact compensation as “there are more and more part-time rheumatologists; when those 55 or older retire, there will be a huge drop in median salary.” Additionally, the higher debt incurred by recent graduates (median indebtedness $150,000 for the class of 2010 according to a 2010 American Association of Medical Colleges report), plus the expense of additional training and decreased insurance reimbursement compared with other specialties, adds to the financial burden in rheumatology, Dr. Harvey says.
