Identification of State-Level Disparities in the Supply, Demand, and Adequacy of Rheumatologists in the United States.

Abstract

Previous research has addressed whether the rheumatologist workforce is adequate to meet future demand. This study analyzed geographic disparities in the supply, demand, and workforce adequacy of rheumatologists across the United States (US). This was a microsimulation of rheumatologists using the Health Workforce Simulation Model for the years 2025 to 2037. Supply and demand were defined as the number of full-time equivalent (FTE) rheumatologists working and required, respectively. Workforce adequacy was defined as the ratio of supply over demand. Workforce trends over the study period were analyzed with linear regression and disparities were analyzed with Chi-squared tests. By 2037, rheumatologist supply was projected at 7,600 FTEs in metropolitan areas while demand was projected at 7,810 FTEs (97.3% adequacy). In contrast, rheumatologist supply was projected at 210 FTEs in non-metropolitan areas while demand was projected at 1,190 FTEs (18.5% adequacy) (P<0.001). By 2037, rheumatologist workforce adequacy was projected to be lowest in the South (73.4%) and highest in the Northeast (128%) (P<0.001). The states with the lowest projected rheumatologist adequacies were Idaho (14.3%), West Virginia (33.3%), Nevada (44.4%), Arizona (45.8%), Arkansas (50.0%), and Wyoming (50.0%). Deficiencies in the rheumatologist workforce are projected to 2037 with a notable maldistribution affecting non-metropolitan areas, the South, and certain identified states. Further efforts are needed to implement strategies that enhance rheumatologist workforce adequacy in areas with identified deficiencies.