Shortage of pediatric rheumatologists often leads to improper diagnosis and treatment

More than 150,000 children in the United States are affected by rheumatic diseases such as juvenile rheumatoid arthritis, lupus, dermatomyositis, scleroderma, and systemic vasculitis. Because of a shortage of pediatric rheumatologists in the country, a majority of these children are not followed by pediatricians trained in the subspecialty, often leading to improper diagnosis and treatment.

In an effort to improve care for children affected by rheumatic disorders, the American Academy of Pediatrics (AAP) wants to educate general pediatricians about important presenting features of these disorders. A presentation was given by Gloria Higgins, Ph.D., M.D., of Columbus Children’s Hospital, discussing specific cases of childhood rheumatic diseases, on Saturday, October 9 at the AAP National Conference and Exhibition in San Francisco.

“The shortage of pediatric rheumatologists means that when a child suffers from a rheumatic disease, they are often treated by adult rheumatologists or general physicians,” said Dr. Higgins, pediatric rheumatologist at Columbus Children’s Hospital and associate professor of pediatrics at The Ohio State University College of Medicine and Public Health. “Infants and children of all ages can be affected by rheumatic disorders, and often their symptoms mimic those of other illnesses. Pediatric rheumatologists are not only trained to make appropriate diagnoses, but are also adept in addressing issues that are different from those in adults, such as limitations as the children grow.”

Currently in the U.S., there are only 160 board-certified pediatric rheumatologists, with many concentrated in big cities. In Ohio, the Rheumatology Center at Columbus Children’s Hospital is one of three in the state. Reasons for the shortage can be linked to the subspecialty’s short history. Board certification in rheumatology was only introduced in 1992, and one-third of U.S. medical schools do not offer programs focused on rheumatic studies.

To help compensate for this shortage and ensure children affected by rheumatic disorders receive the best care possible, Higgins is using the AAP’s Annual Meeting as a forum to educate primary care pediatricians. Recognition of childhood rheumatic disorders will enable these physicians to make appropriate referrals to a specialist.