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Shortage of Rheumatologists.

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#1 Climber


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Posted 05 May 2012 - 04:53 PM

My Rheumatologists office states on their website that there is a shortage of rheumatologists in the US and it is projected to worsen over the next 20 years. It states that the average wait time for a new patient to see a rheumatologist is 2-6 months. It goes on the state that The American College of Rheumatologists recommends using Nurse Practitioners(NP) and Physicians Assistants(PA) to bridge the gap. My first 2 visits as I was gettting diagnosed were with my rheumatologist but now I never see him and only see the PA. She is supervised by him and once when she had a question she brought him up into the room to check me out and when she added Plaquenil she ran down to counsel with him first and he instructed her on the dosage etc.. so everything seems to be directly supervised by him they operate in teams like that where each NP or PA works under a certain doctor. Just wondering since there are people from all over the world and all over the US how it works in your area? Does there seem to be a shortage in your area? Do you see a rheumatologist for every visit or sometimes an NP or PA?

#2 Joelf


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Posted 06 May 2012 - 07:07 AM

Hi Climber,

I'm in the UK and the first port of call is usually to see my general practitioner. In the beginning of my Sclero journey I first saw a young (but thankfully on the ball) general practitioner, who referred me to a local lung consultant who then had the good sense and lack of ego to refer me to a top lung hospital, The Royal Brompton. I was then referred by them to The Royal Free for a rheumatologist's overview by which time I'd already had the treatment for pulmonary fibrosis so now I just see a rheumatologist once a year. Unfortunately, I'm having a little flare up with my lungs at the moment (that'll teach me to feel too smug!! ;) :( ) so I've gone back to my general practitioner who has emailed the Brompton, who hopefully will send me an appointment to see them and have a lung function test. I would expect at that time to be seen by a consultant. I've found that with the NHS (National Health Service) in the UK that once I'm in the Brompton loop they will see me relatively quickly if there is a problem. When I go for checkups in the normal way I'll generally see a consultant/senior registrar, I think, depending on their respective workloads.

However, I do know that compared to some of our members I have been fortunate to be dealt with so promptly and well and I do have excellent backup from my general practitioner, who is quite prepared to listen to my suggestions, doesn't patronise or treat me like an idiot and fully admits that I probably know more about Scleroderma than she does.......which is quite likely true!! ;)
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#3 Snowbird


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Posted 08 May 2012 - 05:36 PM

Hi Climber

Mine seems to be a teaching hospital. One of her trainees will come in and ask me everything first. Then he/she goes out of the room to discuss with her. Then, she comes in to see me as the lead with a couple of them, points things out to them (ie, my hands or whatever) and they discuss/learn while she asks me questions, moves my joints, etc. I only need to see her once a year....hope it stays that way (not that I don't like her of course :D because I surely do!)....it simply means that I'm doing just fine. It can take a long time to get in to a specialist here too sometimes though also due to a shortage of doctors.
Sending good wishes your way!

#4 Teatime


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Posted 09 May 2012 - 09:08 PM

We don't currently have a rheumatologist in my city/area. We did have one but he was awful and he moved away last summer, mostly because I think people stopped going to him. I'm not able to see rheumatologists in Dallas-Ft. Worth because of insurance constraints. We're supposed to get a rheumatologist here in July. I just hope she's a good one! The hospital has been recruiting and interviewing for several months.

#5 JudithL


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Posted 10 May 2012 - 02:07 PM

Hi Climber. I always see my rheumatologist, never an assistant, and it's been that way since my first visit (the day I was officially diagnosed). In addition, I've never had to wait very long for an appointment. If there's a shortage of rheumatologists (or any other specialist, for that matter), it's not apparent in my geographic region. I live on the west coast, by the way. Based on what I have read on this forum, I feel very fortunate to have easy access to excellent medical care.

#6 judyt


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Posted 10 May 2012 - 02:19 PM

Hello Judith,
Welcome to the forums, another one who shares my name, not many of us here. Sorry to hear that you have Scleroderma but great that you feel you are getting good care and attention.

I wonder if it is the West Coast that attracts practitioners and that is why you have no shortage. Those of us who choose to live in other places either by choice or necessity or a bit of both sometimes find it hard. Here in New Zealand there are no specialists so it can take a long time to get a diagnosis, although young grads are coming through now with more knowledge about what Sclero can mean.

It would be interesting to hear your story so, if you have the time and the inclination, keep posting.

Warm Hugs,