World-wide shortage of rheumatologists= getting worse
The worldwide shortage of rheumatologists is getting worse: hold on to your rheumatologist!
If you have difficulty getting in to see a rheumatologist, there are good reasons why.
In 2015, there was a shortage of rheumatologists throughout the US. The American College of Rheumatology (ACR) counted 6,013 rheumatology care providers. 4,997 were full-time rheumatologists, 598 worked part-time, and the other 418 were nurse practitioners and physician assistants specializing in rheumatology. This was 13% fewer rheumatologists than needed by the population, according to the ACR. Since then, the numbers have continued to decrease. Many rheumatologists are retiring, and not enough new ones are entering the specialty. In 2020, 100 doctors who wanted to get into rheumatology training programs could not do so because there were not enough training slots.
By the year 2030, the total number of healthcare providers specializing in rheumatology in the US is predicted to drop from 6,013 to 4,133 nationwide. There will also be a greater need for rheumatologists. The number of older people with arthritis (the baby boomers) will be much higher. It is estimated that there will be only half the number of rheumatology healthcare providers that will be needed to care for rheumatologic patients, such as those with SLE.
Another problem is that many areas of the US have few to no rheumatologists. Many patients have to travel hundreds of miles to see the closest one. 21% of rheumatologists are in the Northeast while only 4% are in the Southwest, and this imbalance is predicted to get worse. There are much fewer people in the population per rheumatologist in the Northeast compared to the Southwest.
A 2019 US study showed that more than 60% of US patients had to wait more than a month to get a new patient appointment with a rheumatologist. More than a quarter of patients had to wait more than 2 months.
It’s much worse for children with rheumatic diseases (such as pediatric SLE). Only 1 of 4 children with arthritis can see a pediatric rheumatologist. Those fortunate to see one have an average of an hour’s drive. Nine states have no pediatric rheumatologists, and six states have only one.
A 2019 United Kingdom study showed that patients waited for an average of over 6 months after the onset of rheumatologic symptoms before being able to see a rheumatologist. So this is not just a US problem.
American College of Rheumatology Committee on Rheumatology Training and Workforce Issues, FitzGerald JD, Battistone M, Brown CR Jr, Cannella AC, Chakravarty E, Gelber AC, Lozada CJ, Punaro M, Slusher B, Abelson A, Elashoff DA, Benford L. Regional distribution of adult rheumatologists. Arthritis Rheum. 2013 Dec;65(12):3017-25. doi: 10.1002/art.38167. PMID: 24284967.
Battafarano DF, Ditmyer M, Bolster MB, Fitzgerald JD, Deal C, Bass AR, Molina R, Erickson AR, Hausmann JS, Klein-Gitelman M, Imundo LF, Smith BJ, Jones K, Greene K, Monrad SU. 2015 American College of Rheumatology Workforce Study: Supply and Demand Projections of Adult Rheumatology Workforce, 2015-2030. Arthritis Care Res (Hoboken). 2018 Apr;70(4):617-626. doi: 10.1002/acr.23518. PMID: 29400009.
Borenstein D. Hug your rheumatologist: the shortage is coming. The Arthritis Connection Summer 2020. Retrieved on 4/11/21 at https://www.thearthritisconnection.com/rheumatoid-arthritis/hug-your-rheumatologist-the-shortage-is-coming
Should lupus patients use medical marijuana?
Medical Marijuana (Cannabis, Cannabinoids, THC, CBD and lupus)
With the increasing popularity and availability of cannabis and CBD, many lupus patients are asking, "How about CBD and lupus?"
Marijuana (cannabis) and its active components (THC and CBD) has become more popular for medical treatments. As of this writing (April 2021), 42 states in the US allow the use of medical marijuana, and 11 states (and the District of Columbia) have fully legalized its use recreationally. Many of my patients ask about using it, so I think it is important to go over some important information about it.
My goal is to present the facts based on scientific evidence without bias.
Cannabinoids are the active compounds of the cannabis plant. There are over 140 different cannabis-derived cannabinoids known, and each acts differently in the body. The 2 most studied and well-known are cannabidiol (CBD) and tetrahydrocannabinol (THC). THC is the cannabinoid responsible for the “high,” intoxicating effects with recreational users. CBD does not make people “high.”
Dry mouth? Dry eyes? Dry itchy skin? Losing teeth? Severe fatigue? Pain? ... learn what you can do!
What to expect at the conference:
- Access to leading experts to hear the latest: You get to ask questions and hear answers live!
- Too shy to ask at a live conference? It is much easier virtually. Just type in your question!
- Around 30% of systemic lupus patients have Sjogren's!
- If you have dry mouth, dry eyes, dry itchy skin, go to www.sjogrens.org to learn more. Consider joining!
- If you are a new patient, learn the important basics
- If you are a seasoned, well-informed patient, we guarantee there will be new stuff
- Learn practical information you can take home to help with:
- Dry mouth, dry eyes, dry itchy skin
- Decrease the loss of teeth
- Lower your risk of fungal infections, thrush, etc.
- Has it been impossible to keep up with work? Understand your job and disability rights
- How did you get Sjogren's? Learn about the genetics behind it!
- How are Sjogren's patients doing during COVID-19 and what should they do?
- 15% - 20% of Sjogren's patients get inflammation of the lungs. Learn what your doctors should do
- New Guidelines published this year thanks to the Sjogren's Foundation
- Exciting, promising drugs are in the research pipeline... learn what they are and how promising they are!
- Tons of products available to improve quality of life. Learn about the latest and greatest
I hope to see you there!
A potential new drug for lupus--
Note that Dr. Thomas' posts are for informational purposes only, and are not meant to be specific medical advice for individuals. Always seek the advice of your healthcare provider with any questions regarding your own medical situation.
DONALD THOMAS, MD