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Stories for Reprint
Critical US Pediatric
Rheumatologist Shortage
By Ferdous Al-Faruque, MARRTC Staff
A report to Congress from the Department of Health and Human Services found there are fewer than 200 certified pediatric rheumatologists to treat the nearly 300,000 children with rheumatic diseases in the United States.
"My children were very lucky because they had a wonderful pediatrician who referred them to a pediatric rheumatologist," says Ann Kunkel the mother of four children with juvenile arthritis. Unfortunately, many children with a rheumatic disease are misdiagnosed or don't receive proper treatment because they don't have access to a pediatric rheumatologist.
The report known as the HRSA Pediatric Rheumatology Manpower study found an unequal distribution of pediatric rheumatologists. In some states there are 3000 children for every pediatric rheumatologist. Even more alarming is the fact that 13 states do not have a single pediatric rheumatologist to treat children with rheumatic diseases.
Inspired by her own experiences Kunkel volunteers for the Arthritis Foundation's Juvenile Arthritis Alliance, which advocates for children with juvenile arthritis and related conditions.
Children who don't have access to a pediatric rheumatologist often see rheumatologists who are trained to treat adult diseases. Kunkel says this can be a problem because adult rheumatologists aren't trained to treat children. "Juvenile arthritis can have a tremendous impact on a child's life," she says. "Children need to be diagnosed early and receive appropriate treatment during all phases of their growth."
Carol Lindsley, professor of pediatrics and chief of pediatric rheumatology at the University of Kansas Medical Center, agrees with Kunkel but adds that the situation in the US is not too different than in other industrialized countries. Lindsley says though the ratio of patients to pediatric rheumatologists is slowly improving, there is still a big shortage. Children who are able to see a pediatric rheumatologist often need to travel long distances to see a specialist. "Most importantly this means these children are at risk of having greater delays in diagnosis." says Lindsley.
The Congressional report estimates that there currently needs to be at least 337 pediatric rheumatologists or a 75 percent increase to meet the needs of children with a rheumatic disease. However, it also cautions that if pediatric rheumatologists are not distributed evenly across the country the problem may persist and incentives may be necessary to attract physicians to areas where they are most needed.
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