TOPLINE

Workforce adequacy projections indicated an unequal distribution of rheumatologists across the US with only 18.5% in nonmetropolitan areas compared with 99.3% in metropolitan regions and certain states and districts projected to have the lowest adequacy levels, including Idaho, projected to have an adequacy of 14.3%, by 2037.

METHODOLOGY

• Researchers used data from the Health Workforce Simulation Model developed by the Health Resources and Services Administration (HRSA) to conduct a microsimulation of the rheumatologist workforce in the US, with projections from 2025 to 2037.
• Supply was defined as the number of full-time equivalent (FTE) rheumatologists working in the US, with FTEs defined as physicians working 40 h/wk.
• Demand was defined as the number of FTE rheumatologists needed to meet the healthcare needs of the US population based on current healthcare usage under status quo conditions, with projections up to 2037 derived from Medical Expenditure Panel Survey data and physician staffing ratios from the American Medical Group Association.
• The geographic areas for assessing workforce adequacy were defined by HRSA and included metropolitan status, US regions, and individual states.
• Workforce adequacy was calculated as the ratio of supply to demand.

TAKEAWAY

• National rheumatologist supply is projected to increase from 7810 FTEs in 2025 to 8780 FTEs by 2037 (12.4% increase; P < .001), whereas demand is projected to increase from 9010 FTEs to 9810 FTEs (8.9% increase; P < .001), with workforce adequacy improving from 86.7% to 89.5% (P < .001).
• Rheumatologist workforce adequacy in nonmetropolitan areas was significantly lower than that in metropolitan areas in 2025 (17.5% vs 97.3%; P < .001), and it is projected to remain lower in 2037 (18.5% vs 99.3%; P < .001).
• Regional analysis revealed that in 2025, the South had the lowest workforce adequacy at 74.7% and the Northeast had the highest adequacy at 120% (P < .001). By 2037, workforce adequacy is projected to remain lowest in the South at 73.4% and highest in the Northeast at 128% (P < .001), with 37 states projected to have adequacy < 100%, including 19 states with adequacy < 70%.
• State-level analysis identified that the District of Columbia, Massachusetts, Connecticut, New York, and Maryland had the highest workforce adequacy in 2025, whereas Idaho, West Virginia, Iowa, Nevada, Mississippi, North Dakota, and Wyoming had the lowest adequacy. Projections for 2037 showed that adequacy would decline further in Idaho.

IN PRACTICE

“Projected deficiencies in rheumatologist workforce adequacy suggest a need for multiple strategies to improve access to rheumatologic care moving forward. Key stakeholders in the specialty, including public policy makers and state governments, should align on the initiatives necessary to enhance rheumatologist workforce adequacy, especially among geographic areas with identified deficiencies,” the authors wrote.

SOURCE

This study was led by Jason Silvestre, MD, Medical University of South Carolina in Charleston, South Carolina. It was published online on May 25, 2026, in Arthritis Care & Research.

LIMITATIONS

The simulation model provided only state-level projections despite performing county-level assessments of patient populations and rheumatologist supply. Pediatric rheumatology subspecialties were not modeled. Advanced practice providers such as nurse practitioners and physician assistants were excluded from workforce modeling. Part-time physicians were not modeled separately. The model did not provide differences between private practice and academic rheumatologists.

DISCLOSURES

This study did not report any specific funding. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.