Shortage of Pediatric Rheumatologists Can Lead to Substandard Care

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.

Columbus Children’s ranks among the top 10 in National Institutes of Health research awards and grants to freestanding children’s hospitals in the country and houses the Department of Pediatrics of The Ohio State University College of Medicine and Public Health. With nearly 600,000 patient visits each year, Children’s Hospital is a 112-year-old pediatric healthcare network treating newborns through age 21. In 2003, the Columbus Children’s Research Institute conducted more than 300 research projects and is the home of Centers of Emphasis encompassing gene therapy; molecular and human genetics; vaccines and immunity; childhood cancer; cell and vascular biology; developmental pharmacology and toxicology; injury research and policy; biopathology; microbial pathogenesis; and biobehavioral health. Pediatric Clinical Trials International (PCTI), a site management organization affiliated with the hospital, also coordinated more than 50 clinical trials. In addition to having one of the largest ambulatory programs in the country, Children’s offers specialty programs and services. More than 75,000 consumers receive health and wellness education each year and affiliation agreements with nearly 100 institutions allow more than 1,700 students and 500 residents to receive training at Children’s annually. More information on Children’s Hospital of Columbus is available by calling (614) 722-KIDS (5437) or through the hospital’s web site at http://www.columbuschildrens.com.