Addressing rheumatology workforce shortages has been a top legislative priority for the ACR for many years. We recently succeeded in getting the federal Pediatric Subspecialty Loan Forgiveness program reapproved and are actively working with our partners to get Congress to fund that critical program. Even without a federal solution, however, pediatric rheumatologists in Washington will soon be able to apply to state loan forgiveness programs.
The 2021–23 budget passed in Washington instructs the Washington Health Corps to consider pediatric rheumatologists for state loan forgiveness programs during the 2019–21 and 2021–23 cycles. This is the first time a state has included any rheumatologists in its loan forgiveness programs. It also marks an important first victory in the ACR’s recent efforts to address the workforce shortage through state initiatives.
Committed Efforts
This win would not have been possible without key legislative champions. In the previous legislative year, a standalone bill (HB 2852) was introduced by Rep. Gina Mosbrucker (R-14th district) and co-sponsored by a bipartisan group of representatives. That bill was based in part on the cognitive specialist loan forgiveness model legislation developed by the ACR. During the drafting process, the bill was narrowed down to include only pediatric rheumatologists. Although the bill was not successful, the sponsors’ continued commitment to the effort is ultimately what led to this significant win.
Loan forgiveness for rheumatologists and other cognitive specialists is a difficult topic. Most are not included in federal and state programs due to some common misconceptions. The chief misconception is that all specialists earn exceptionally high incomes. Overcoming this requires a significant amount of discussion with legislators and staff. Many are shocked to learn that pediatric subspecialists often earn less than their general pediatric counterparts.
The other common misconception is that rheumatologists are already eligible for loan forgiveness programs. Even departments tasked with overseeing these programs often believe that rheumatologists already qualify under the internal medicine umbrella. However, that is incorrect, and most federal and state programs specifically exclude internal medicine subspecialists. These are significant barriers, but they can be overcome with dedicated legislative champions and partners, such as those who supported the Washington effort.
If you are a pediatric rheumatologist in Washington, you can find more information about the loan forgiveness programs at the Washington Health Corps website. If you apply, email the ACR advocacy staff at [email protected] and tell us if you are approved or denied so we can let the bill sponsors know if additional action is necessary.
Joseph Cantrell, JD, is the senior manager of state affairs for the ACR.
