Achy conditions that attack the joints, muscles and bones are an issue that affects individuals of all ages; and can lead to issues that have the potential to incorporate internal organs. The complexity of these ailments calls for the expertise of a specialist trained to identify and treat such concerns. According to the American College of Rheumatology (ACR), there are over 100 complex and intriguing diseases that fall under the internal medicine specialty of rheumatology with more than 50 million Americans in need of the specialized care of a rheumatologist.
What is a Rheumatologist?
A rheumatologist is a doctor that specializes in treating patients with diseases affecting their joints. The primary role of this type of physician is to detect, identify, treat and medically manage individuals who have arthritis and other rheumatic diseases that can cause issues with a patient's joints, muscles, bones and even internal organs, such as the kidneys, lungs, and the brain. While the majority of patients that a rheumatologist sees typically has a condition associated with arthritis, other cases may also involve autoimmune diseases such as lupus, Sjögren's syndrome, scleroderma, and fibromyalgia.
Rheumatologists are primarily trained to:
Rheumatologists care for a wide array of patients—from young children to senior citizens – with a goal to eradicate, treat, and/or maintain quality of life as it pertains to an individual case. In addition to battling arthritic conditions (from osteoarthritis to infectious arthritis), the typical patient that a rheumatologist sees may also suffer from bursitis, gout, Lyme disease, osteoporosis, tendonitis, and vasculitis.
With more than 30 years of private practice under his belt, rheumatologist Neal S. Birnbaum, MD, says that any aggravation associated with the hassles of running a small office fade away as soon as he enters the examination for one-on-one interaction with a patient.
"I particularly enjoy new patient consultations, for that is when I must truly use my interviewing skills and diagnostic abilities," says Dr. Birnbaum in an article titled Why I Still Like Being a Rheumatologist. "I like the fact that I have only an hour to decipher a patient’s history, perform a physical exam, review old records, make a diagnosis, explain my conclusions to the patient, and institute appropriate therapy."
A doctorate degree is the entry-level educational requirement for rheumatologists.
Step by Step Educational Path of How to Become a Rheumatologist
According to a questionnaire administered by the American College of Rheumatology Training and Workforce Committee, the majority of rheumatology fellows had their initial exposure to rheumatology as second-year and third-year medical students; and more than 75 percent surveyed said they solidified their decision to pursue the field during their internship and residency program.
The primary work environments of a rheumatologist are found within a medical office or clinic, but these specialists also provide care in many different healthcare settings – from a private physician-owned practice to outpatient clinics. Rheumatologists may also work out of inpatient units that provide medical, surgical, rehabilitation and transitional care. Universities, colleges, and pharmaceutical companies also hire rheumatologists to conduct research regarding the causes of rheumatic diseases and the development of alternative treatments.
Employers hiring rheumatologists typically seek the following qualities in a job candidate:
To increase the chances of being hired and finding relevant job leads, joining a professional association or organization is highly recommended.
One of the leading resources and links to networking possibilities is the American College of Rheumatology (ACR), which focuses on education, treatment and research related to the field. Representing more than 9,000 rheumatology health professionals, additional membership benefits include research opportunities, fellowships, educational discounts, and access to the latest information through rheumatology-related publications.
Additionally, keeping abreast on the current issues and trends related to the management and treatment of rheumatic diseases is important for shaping a well-informed job candidate. Subscribing to local publications, newsletters, and medical journals is highly recommended. The Rheumatologist is a newsmagazine that specifically caters to the field of rheumatology and serves more than 11,000 healthcare professionals.
The average earnings of a rheumatologist is cited as being $214,000 in 2013, according to Medscape's Compensation Report for Rheumatologists (2014), which also identifies this specialty as falling below the middle among all other physicians.
The median salary for the occupation varies according to a handful of factors that include gender, workplace environment, self-employment, and geography. For example, the highest rheumatologist earners in the United States reside in the North Central and Southwest regions ($368,000 and $264,000, respectively), while the majority of the lowest-paid earners live in the South Central area ($166,000) and the Northwest ($167,000).
Interestingly, the Medscape Physician Compensation Report (2014) also states that the field of rheumatology has seen a significant increase of 15% in compensation, which contrasts greatly to the 6% increase of the closest highest-earning medical specialties. Although rheumatology showed this particular increase, Medscape also reports that salaries regarding this specialty have been more stable in prior years.
Nonetheless, the overall job outlook for rheumatologists is quite promising, and will only continue to grow as arthritic conditions are a common ailment amongst the aging. An increased population in the U.S. (which on the average, is living longer), will create a higher demand for specialists of rheumatic conditions.
Additionally, there is a demand to fill growing rheumatologist positions across the nation, as the coming decades have been projected to experience a substantial shortfall in the number of practicing adult and pediatric rheumatologists in the U.S.
Starting a Private Practice…
As a whole, rheumatologists make more money in private practice than in any other setting (with the exception of outpatient clinics), which is one benefit to establishing a solo medical business. Self-employed rheumatologists earn an average of $234,000, whereas those employed in other work environments (like hospitals, healthcare organizations, and the government) earned an average salary of $195,000. For physicians thinking about establishing their own medical practice, there are a few primary factors to note.
The start-up costs of a rheumatology private practice are one of the first things to evaluate; all of which involves a range of financial commitments that need to be covered before a practice can accept patients, and really start to pull in a profit. A physician must create a budget that includes initial costs and ongoing expenses to determine whether a loan, savings account, or personal cash flow will fund his or her private practice. Common expenditures include renting office space, insurance, license and operation fees, office equipment, furnishings, and hiring staff, if necessary.
Building a reputation as a reliable rheumatologist helps grows a private practice, which means being available to patients – whether it's returning phone calls or accommodating scheduling changes. It is this type of customer service and attentiveness from a doctor that spreads like wildfire throughout a community. Word-of-mouth is one of the best ways to increase a patient roster as a self-employed rheumatologist. Additional advertising and marketing options may include newspaper ads, attending health fairs, organizing an open house, connecting with local support groups, and accepting speaking engagements.
Since the majority of patients that a rheumatologist sees originate from primary care physician referrals, it is highly recommended to network with area doctors, practices, and hospitals to establish connections throughout a local medical community.
Rheumatologists not only make more money than other physicians, but are also noted to experience a lower level of career burnout than other specialty doctors. A common stressor amongst rheumatologists has nothing to do with the career field itself, but centers on dealing with "too many bureaucratic tasks" – something that can feel magnified when running a private practice. Keeping up with the paperwork of running a private practice plays an important role in the day-to-day tasks which can take away from the amount of time spent seeing patients.
According to Marcy B. Bolster, MD, director of the Rheumatology Fellowship Training Program at Massachusetts General Hospital in Boston, rheumatologists spend an increasing amount of time in the current healthcare environment filling out pre-authorization forms for medications and diagnostic studies, as well as experience additional stressors centered on documentation associated with the electronic health record.
In conclusion, becoming a rheumatologist means entering a career field that places a physician in an important position to alleviate pain and enhance the quality of life for patients suffering from some of the most common ailments, such as arthritic conditions. With an aging Baby Boomer population across the U.S. leading to an increased need for the expertise and care of rheumatology specialists, plenty of employment opportunities await both salaried physicians and those who establish a private practice.
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