The Challenge of Addressing the Rheumatology Workforce Shortage

Abstract

The rheumatology workforce faces a deficit of physicians trained to provide high-quality care to patients with rheumatic diseases, and this deficit is projected to worsen over the next 10 to 15 years in many countries and regions around the world. Rheumatology workforce studies carried out in the US, Canada, and in Europe have revealed expected shortages driven by projections for increased demand; changes in demographics among providers, including increasing proportions of women and part-time clinicians as well as high levels of expected retirements; and geographic maldistribution of providers.1,2,3,4,5 In the last 2 years, practice changes caused by the coronavirus disease 2019 (COVID-19) pandemic have affected, and likely exacerbated, workforce limitations.

Identifying antinuclear antibody positive individuals at risk for developing systemic autoimmune disease: development and validation of a real-time risk model

“…This risk model can be automated and deployed in real-time with no input needed from a clinician. In the setting of an international shortage of rheumatologists ( 14 – 16 ), a risk-stratifying tool for positive ANA individuals is critical. For future directions, we are assessing our risk model in real-time in the EHR prospectively and its impact on time to diagnosis and treatment for autoimmune diseases.…”

“…Only 11-20% of individuals with a positive ANA have an autoimmune disease diagnosed at referral (4,(10)(11)(12)(13). Frequent ANA referrals in the setting of an international shortage of pediatric and adult rheumatologists (14)(15)(16) contribute to inefficient use of limited resources and lengthen wait times for rheumatology consultation (1,9,12).…”

Advanced practice providers in infectious disease: Enhancing the infectious disease team of the future

“…In 2015, the American College of Rheumatology noted a gap in the growing demand and available workforce and thus strategized recruitment of APPs into rheumatology. 14 The Association of Rheumatology Professions and Rheumatology Research Foundation developed educational resources and learning modules as well as a Rheumatology Curriculum Outline as integration and recruitment tools specifically for APPs and made them widely available. 15 Grants were also offered to practice groups recruiting APPs to alleviate the decreased production while onboarding and educating new providers.…”

“…While the use of APPs in ID is a burgeoning topic, with a goal of reducing the current mismatch of trained specialists in the context of a growing patient population, other specialties have also grappled with how to successfully integrate and retain APPs. In 2015, the American College of Rheumatology noted a gap in the growing demand and available workforce and thus strategized recruitment of APPs into rheumatology 14 . The Association of Rheumatology Professions and Rheumatology Research Foundation developed educational resources and learning modules as well as a Rheumatology Curriculum Outline as integration and recruitment tools specifically for APPs and made them widely available 15 .…”

Integrating Infectious Disease Advanced Practice Providers in the Workforce: An Educational Step Forward

“…In 2015, The American College of Rheumatology noted similar shortages in their workforce. The Association of Rheumatology Professions and Rheumatology Research Foundation developed specific resources and learning modules for APPs to aid practices in onboarding and incorporating APPs [ 7 ]. Fiscal resources were also offered to offset any lost revenues while onboarding and training APPs [ 8 ].…”