Review Article - International Journal of Clinical Rheumatology (2023) Volume 18, Issue 4

Compensating for the lack of rheumatologists a comprehensive strategy

Miloslavsky M*

Massachusetts General Hospital, Department of Medicine, Division of Rheumatology, United States

*Corresponding Author:
Miloslavsky M
Massachusetts General Hospital, Department of Medicine, Division of Rheumatology, United States

Received: 25-Mar-2023, Manuscript No. FMIJCR-23-96754; Editor assigned: 27- Mar-2023, Pre-QC No. FMIJCR-23-96754 (PQ); Reviewed: 10-April-2023, QC No. FMIJCR-23-96754; Revised: 13-April-2023, Manuscript No. FMIJCR-23-96754 (R); Published: 20-April-2023, DOI: 10.37532/1758-4272.2023.18 (4).75-77


A significant challenge facing the field of rheumatology is the projected gap between the growing demand for rheumatologists and the available pool. In order to ameliorate access to care, accelerating the rheumatology pool is needed. Herein we bandy implicit results to the anticipated pool deficit, including 1) expanding the training of rheumatology croakers; 2) adding nanny guru, croaker adjunct and druggist application in rheumatology practice; 3) growing the use of telemedicine; and 4) reducing collapse in order to retain rehearsing rheumatologists. Structure on the being literature in these areas, we propose a multifaceted approach to addressing the rheumatology pool deficit.


Rheumatology • Telemedicine • Rheumatic diseases • Rheumatology physicians • Nurse practitioners


In the coming decades, the field of rheumatology will have tremendous openings while facing mounting pressures. Advances in wisdom and medicine development continue to ameliorate issues in cases with rheumatic conditions. Still, the capability of the field to continue to deliver outstanding care is facing significant challenges. By 2040, the number of United States (U.S.) grown-ups diagnosed with arthritis is projected to increase by 49, to78.4 million. Other rheumatic conditions will also increase in frequence due to aging of the baby boomer generation and adding life expectation. At the same time, a significant space in the adult rheumatology pool is anticipated. The 2015 American College of Rheumatology( ACR) Workforce Study projected that by 2030 adult rheumatology providers( croakers , nanny interpreters and croaker sidekicks), will decline by 25, in terms of full time coequals( FTEs), performing in demand exceeding the force of rheumatology providers by 102. Multiple factors contribute to this protuberance, including anticipated withdrawal of nearly 50 of the current pool, the adding number of women and millennials entering the field and smaller providers anticipating entry into community practice. This imbalance is likely to be indeed lesser in pastoral areas of the country. The mismatch between awaited demand and force for rheumatology providers represents one of the biggest challenges facing our specialty. Herein we bandy implicit results to the anticipated pool deficit. Specifically, we will concentrate on four main targets for intervention 1) expanding the training of rheumatology croakers; 2) adding nanny guru, croaker adjunct and druggist application in rheumatology; 3) growing the use of telemedicine and 4) reducing collapse in order to retain rehearsing rheumatologists [1, 2].

Material and Methods

Adding application of advanced practice providers

Nanny interpreters and croaker sidekicks

With an adding gap between force of and demand for the rheumatology pool it's imperative to increase the number of

interpreters available to give care for cases in need of rheumatic complaint evaluation and operation. It's clear that indeed a doubling of the number of rheumatology fellows entering the field won't meet the increased demand assessed on the rheumatology pool. Nanny interpreters (NPs) and croaker sidekicks (papas) represent rheumatology associates who can extend the reach of the delivery of rheumatic complaint care. There are numerous places for NPs and papas in an inpatient practice, including but not limited to, furnishing follow up care, critical movables for established cases, patient education, test results follow up for cases, response to patient phone calls, as well as new patient evaluations [3]. A recent check of the places of NPs and papas in rheumatology practice set up that nearly 100 see cases in routine or critical follow- up and overhead of 70 of NPs and papas are performing new patient evaluations. NPs and papas in a rheumatology practice not only ameliorate access to care but also have been shown to deliver high- quality care. It has been demonstrated that rheumatology advanced practice providers( APPs; NPs, papas) demonstrate a significant degree of independence, only sometimes seeking guidance from their supervising croaker associates, and this independent practice provides a strong platform on which to depend for pool expansion. There are probably a subset of conditions for which NPs and papas will exceed in care delivery, and there's substantiation to support that NPs and papas are facile with diagnosing RA, making drug adaptations and exercising treat- to- target strategies. Importantly, in considering the part of NPs and papas in rheumatology practice, as compared to rheumatologists, it's also cheering to fete that they've demonstrated analogous acceptance situations by cases [4, 5].

NPs and papas gain a broad education as part of their training similar that they're suitable to enter numerous different fields or specialties. Whereas rheumatologists follow a specific training path that includes IM occupancy and rheumatology fellowship training, NPs and papas don't admit this focused education and training. While the hiring of an APP to a practice provides the eventuality for bettered access to care, this isn't an incontinently felt advantage as it's honored that new NPs and papas bear time for learning as well as integration into the practice [6]. The ACR, Association of Rheumatology Professionals (ARP) and RRF admit the benefits for NPs and papas in rheumatology practice by having rheumatology-specific educational coffers and specialty-specific literacy modules across the breadth of rheumatology practice. Also, a Rheumatology Curriculum Outline was created to help NPs and papas new to a rheumatology practice most efficiently expand their rheumatology fund of knowledge and integrate into the practice. Knowing that time is needed to train a NP or PA in rheumatology, as well as for the NP or PA to come familiar with the practice patterns of the rheumatologists within the practice, the RRF offers subventions to ease the fiscal burden of reduced productivity for the croaker and NP or PA while the APP becomes incorporated into the practice. In addition to “on- the- job” training for an APP to integrate into the practice, two academic institutions have been innovative with a rheumatology fellowship training program for APPs. While the before program at University of Texas- South-western, 2004- 2008, is no longer available due to lack of backing support, the occasion for rheumatology fellowship training for APPs is available at Duke University at the time of this jotting [7].


In the setting of adding demand for and declining rheumatology providers, the rheumatology pool faces a tremendous gap, and this will innately limit access to care. We must take amulti-faceted approach to accelerating the rheumatology pool to ameliorate access to care for those with rheumatic conditions. Not only will this involve the training of further rheumatology fellows, attracting advanced practice providers, including NPs, papas and clinical druggists, to the specialty, broader perpetration of telemedicine, but it's also imperative that we examine the factors important in retaining the strength of the current rheumatology pool [8].

Conflict of Interest





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