Seven states do not have any pediatric rheumatologists. Florida is more fortunate, with about 17. But health experts say that relative abundance is hardly adequate in a state brimming with more than 21 million residents.
Indeed, entire areas of the state go without such a specialist. The Florida Panhandle, for example, has no full-time pediatric rheumatologist.
The University of Florida College of Medicine, part of UF Health, has been awarded a grant to fund a pediatric rheumatology fellowship as part of a national effort to alleviate the desperate shortage of specialists nationally. The grant by the Tampa-based Purple Playas Foundation and the Arthritis Foundation provides $150,000 in matching funding for up to three years of fellowship training.
Fellowships are an integral part of a physician’s education, providing advanced training in medical specialties or subspecialties. Rheumatologists treat autoimmune and inflammatory diseases that primarily affect the body’s musculoskeletal system. These diseases can affect the joints, muscles and bones and include many types of arthritis, lupus, osteoporosis and many other ailments.
“Funding is getting harder and harder to come by for rheumatology fellowships,” said Melissa E. Elder, M.D., Ph.D., a professor in the UF College of Medicine’s department of pediatrics and chief of its division of allergy, immunology and rheumatology. “Probably fewer than 20 residents go into pediatric rheumatology each year across the nation. That’s not a lot of rheumatologists.”
Elder said UF Health is grateful for the award and knows it can make a difference.
Other medical centers receiving fellowship grants are the University of California San Francisco, the Children’s Hospital Colorado Foundation, the Seattle Children’s Hospital and the Duke University Medical Center.
“The shortage of pediatric rheumatologists is really severe,” said Rochelle Lentini, who created the Purple Playas Foundation with her husband and son, who suffers from juvenile arthritis. “We’ve always been looking ahead, thinking of how we can help with a solution. The big solution is that people need to be attracted to this field so that we have more eyes on juvenile arthritis so we can find a cure.”
The Arthritis Foundation said a child with arthritis currently travels an average of 57 miles to be seen by a pediatric rheumatologist.
“The new 2020 fellowship awards will help enable thousands of children to be seen sooner, travel a shorter distance and align with the Arthritis Foundation goal to have customize care for children with juvenile arthritis,” said Melissa Hughey, the Arthritis Foundation executive director.
The UF Health pediatric rheumatology group with its four specialists is the largest in Florida and the only program in the state with a fellowship in pediatric rheumatology that is accredited by the Accreditation Council for Graduate Medical Education.
Attracting outside funding, however, for that fellowship and others around the nation at other institutions has proved challenging, Elder said.
“Now we don’t have to worry too much about where the money is coming from,” she said. “We’re the only fellowship program in the state. It’s important for Florida to have a fellowship program as the third most-populous state.”
The reason for the shortage of pediatric rheumatologists remain perplexing, Elder said. Some argue the fact that rheumatology fellowships are three years instead of the usual two dissuades physicians from entering the field. Others note salaries for rheumatologists lag behind other specialities.
In any case, solutions are urgent. The average age for practicing pediatric rheumatologists is 50, officials say, and looming retirements are expected to exacerbate the shortage.