Pediatric rheumatologist shortage a serious barrier to care for children
ORLANDO — There are less then 350 pediatric rheumatologists currently practicing in the United States, representing a substantial barrier to care for the 300,000 children with arthritis, 30,000 with systemic lupus erythematosus and 3,000 with juvenile dermatomyositis across the country, according to Cathy Patty-Resk, MSN, RN-BC, CPNP-BC, president-elect of the Rheumatology Nurses Society.
“The average age of a pediatric rheumatologist in the United States is 50 years, which means in the next 15 years, all of these folks are going to be retiring,” Patty-Resk, who practices at the Children’s Hospital of Michigan, told attendees at the 2019 Rheumatology Nurses Society Annual Conference. “The rheumatology fellowships are not filling their positions, and that means we are going to have even fewer pediatrician rheumatologists coming up.”
As of 2017, nine states — mostly across the mid-West — had zero pediatric rheumatologists practicing within their borders, according to Patty-Resk, including Nevada, Idaho, Montana, Wyoming, New Mexico, Oklahoma, South Dakota, West Virginia and New Hampshire. Meanwhile, North Dakota, Nebraska, Louisiana, Kentucky and Rhode Island each had only one practicing pediatric rheumatologist that year, and Arkansas, Mississippi, Vermont and Maine only had two each.
California led the nation in the number of pediatric rheumatologists at the time with just 47.
“In Detroit, where I am, it’s just me and a rheumatologist,” Patty-Resk said. “Some states have many pediatric rheumatologists, but part of the problem is that not all of those people are fulltime working rheumatologists. Many are just part-time academic, or part-time clinical.”
According to Patty-Resk, the national average distance traveled to see a pediatric rheumatologist is 57 miles, compared with an average 25 miles traveled to visit other pediatric specialties.
Due to all of these factors, only a quarter of children with arthritis are receiving proper care and treatment, she said.
“That means that pediatric rheumatologists and pediatric providers are not taking care of these kids,” Patty-Resk said. “These kids are being taken care of by pediatricians, primary care, family practice and other folks.”
She later stressed the need for more pediatric providers trained in pediatric rheumatology, as well as loan forgiveness for physicians in pediatric rheumatology fellowship programs, ongoing rheumatology courses and telemedicine.
“I sit in a room full of residents in attending in our clinic, and when we have our limited downtime, I engage the residents in conversation,” Patty-Resk said. “These are people who are coming out of school with $400,000 of debt, and that is before they even think about a fellowship. They really need some help. This is serious.” – by Jason Laday
Patty-Resk C. Access to care. Presented at: Rheumatology Nurses Society Annual Conference; Aug. 7-10, 2010; Orlando, Florida.
Disclosure: Patty-Resk reports advisory board membership with Novartis and Sandoz.