Results of the first rheumatology workforce study in the past 10 years were released last November, confirming concerns that the supply of rheumatologists may not meet demand in the near future. The extensive report, commissioned by the ACR, lays out the hard facts about this medical specialty that its practitioners had long anticipated were true—the number of practicing rheumatologists does not meet the current or future needs of the patient population, patients are waiting longer for appointments, and practices must be redesigned to preserve and improve the quality of the profession.
In a response to the 2006 Rheumatology Workforce Study, President Neal S. Birnbaum, MD, told attendees at the ACR Annual Meeting in Washington, D.C., last November that the workforce report—and the professional specialty—are a study in contrast. “Never has there been such a rich period of opportunity for rheumatologists to improve the lives of their patients,” says Dr. Birnbaum. “Yet the American College of Rheumatology knows that our members confront significant challenges in a rapidly changing environment: declining reimbursements, increasing paperwork, and complex, confusing, and at times inexplicable demands from insurance companies and government.” In addition, Dr. Birnbaum says, “Practitioners face increasing demand for services at a time when our aging rheumatology workforce might typically intend to reduce its workload.”
Supply and Demand Snapshot
Dr. Birnbaum’s remarks echo the findings in the workforce study. The genesis of the study was an advisory group formed by the chairman of the ACR Committee on Training and Workforce Issues, Walter Barr, MD, and led by Chad Deal, MD. ACR members informally had discussed perceptions of a shortage among rheumatologists and knowledge of longer wait times for patients as well as difficulty in recruiting practice partners. The study, says Dr. Barr, allowed the ACR to validate and reinforce these general impressions and outline potential solutions and formal goals. The advisory group first met in early 2005 and immediately sought the expertise of The Lewin Group, a Falls Church, Va., consulting firm that specializes in strategic and analytical services in healthcare and human services.
The purpose of the study was to better understand the factors affecting the supply of and demand for rheumatologists, to quantify factors where possible, to project likely paths for the evolution of the workforce, and to assess its implications. As part of the study, The Lewin Group conducted a survey of practicing rheumatologists between November 2005 and February 2006. The analysis also included a literature review and guidance and input from advisory group members.
- The study results cover the following areas:
- Demographics of current rheumatologists;
- Current practice patterns and trends;
- Prevalence of diseases requiring the expertise of a rheumatologist;
- Technological advances that have affected the need for this specialty profession;
- Changes in practice efficiency;
- Supply and demand;
- Retirement trends;
- Adult versus pediatric rheumatologists;
- Earnings and job satisfaction; and
- Distribution of work hours.
The workforce study projects that the number of rheumatologists in adult practice will increase only 1.2% between 2005 and 2025. However, the demand for rheumatologists to treat patients in that time period will rise 46%. Analysts say the increase in demand will come from several factors: an overall increase in the population, an increase in the number of elderly patients, and a general rise in per capita income.