Jeri Stracner, 48, thinks nothing of driving an hour from her home in Carlisle, Kentucky, to see a rheumatologist in Lexington. Of course, that’s on a good day. On a bad day - say, if she gets stuck behind a tractor or someone hauling tobacco bales - the 45-mile trip to visit a rheumatology expert could take up to two hours.
Given the drive she’s willing to make to see this doctor, you might think he provides a level of service that can’t be found elsewhere. Turns out he’s simply the nearest rheumatologist. For those who don’t live near a major city, long drives to see rheumatologists are common. People in metropolitan areas may live close to a rheumatologist, but they, too, experience the effects of their doctor being overbooked, busy and in demand.
Since Stracner first began seeing her rheumatologist 13 years ago for rheumatoid arthritis (RA) and fibromyalgia, the rheumatology practice has gotten so busy it takes two or three days just to get a return call from a nurse. At least she’s not a new patient; average wait times for those appointments are three months or more. Stracner essentially competes for her doctor’s time.
Waiting to see a rheumatologist is more than just inconvenient. “For new patients, there’s a window of opportunity for starting treatments that can delay progression of the disease,” says Ramesh Pappu, MD, a rheumatologist at Albert Einstein Medical Center in Philadelphia. “If treatment is delayed for several months, permanent joint damage could occur. That’s something rheumatologists are concerned about.” And for established patients who can’t get in to see their rheumatologists, medication adjustments and critical laboratory tests could be delayed.
Currently, 46 million [update October 2010: 50 million] people have had a doctor tell them they have a form of arthritis, such as osteoarthritis (OA) or RA, or a related condition, such as lupus, gout or fibromyalgia. Within 25 years, as the over-60 population peaks, that number is expected to reach 67 million. And those figures don’t take into account the millions more who have joint symptoms and may need to see a doctor to find a diagnosis. They initially may see their family physician but then request to see a rheumatologist or be referred to one. This growing demand for rheumatologists could significantly affect care for millions of Americans.
What we know
The American College of Rheumatology (ACR) – the leading professional organization for rheumatologists, scientists and health-care workers who treat those with rheumatic diseases – began to study the situation two years ago. The results were released at its 2006 Annual Scientific Meeting.
The good news: The number of new rheumatologists has risen in recent years, from 122 in 2000 to 168 in 2006 – a 37 percent increase. The bad news: The healthy sounding growth will be outpaced by the rate of retirement. The ACR Workforce Study estimates that about half of practicing rheumatologists will retire within just eight years and that by 2025 there will be a shortage of 2,600 rheumatologists in the U.S.
I hope we could all leading a happy life with a professional dotor's assistance :-)
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