Number of APPs in adult rheumatology rose 141% in last decade
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Key takeaways:
- The number of U.S. rheumatologists in adult care increased 23% since 2009.
- Women made up 43% of rheumatology providers in 2019, though they were more likely to exit the workforce.
The number rheumatologists in adult care rose 23% from 2009 to 2020, while the number of advanced practice providers in the specialty exploded by as much as 141% during the same time, according to data published in Arthritis & Rheumatology.
However, despite the apparent increase in the rheumatology workforce over the last decade, that growth “appears to be flattening off in later years,” the researchers wrote.
“Prior workforce studies have projected significant shortages of rheumatology providers, with the increase in the supply of providers unable to keep up with the demands of the aging U.S. population,” Melissa L. Mannion, MD, MSPH, of the University of Alabama at Birmingham, and colleagues wrote. “Previous workforce studies have relied on [Association of American Medical Colleges] and [American College of Rheumatology] membership enrollment data, which may not fully reflect practicing physicians.”
To overcome those limitations in assessing the current adult rheumatology workforce in the United States, Mannion and colleagues examined national Medicare claims data from 2006 to 2020 for all patients with a diagnosis of inflammatory rheumatic disease, as well as a 5% sample of all Medicare enrollees.
For each calendar year, the researchers defined eligible providers as either newly entering the workforce — ie, not identified in prior calendar year — stable — or identified in previous and subsequent calendar years — or exiting the workforce — ie, not identified in subsequent calendar years. They then evaluated each provider’s age, gender, practice type and location in multiyear periods. The demographics of rheumatologists entering and exiting the workforce were compared with those of “stable” providers using logistic regression.
According to the researchers, the clinically active adult rheumatology workforce in 2019 included of 5,667 rheumatologists and 379 advanced practice providers. Although the number of rheumatologists increased 23% from 2009 to 2020, this growth has appeared to have stalled in later years, with fewer active in 2020 than the previous year. Meanwhile, advanced practice providers, saw an increase of 141% over the same decade.
The number of female rheumatologists had gradually increased to 43% in 2019. However, women were more likely to exit the workforce. Rheumatologists counted in the study were more likely to be employed by a health care system vs. a small practice. They were also less likely to be located in southern states.
“Even with the growth of the rheumatology workforce supply identified in this analysis, there remains a greater demand for rheumatologic care that may need to be solved with more efficient care through digital health tools such as remote therapeutic monitoring, precision medicine and others,” Mannion and colleagues wrote. “The results of this analysis can be used to inform additional studies and future policies to promote growth of the adult rheumatology workforce and alternative solutions to providing rheumatologic care to the U.S. adult population.”
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