The Australian Rheumatology Association says the number of funded advanced training places needs to at least double to address the undersupply of rheumatologists across the country and avoid an impending workforce crisis.

To improve access to affordable care, it is calling on State and Federal Governments to fund extra adult and paediatric rheumatologist places.

It also wants more public hospital positions and more support for rural positions.

There are currently 380 adult and 20 paediatric rheumatologists nationally, with the specialist training program producing about 18 rheumatologists each year.

Speaking at the ARA’s Annual Scientific Meeting this week, former president Professor Catherine Hill said this fell well short of the 682 adult and 61 paediatric rheumatologists that are ideally needed to provide services to the population.

The figures are based on the benchmarks of two rheumatologists per 100,000 adult population and one paediatric rheumatologist per 200,000 children.

Currently, Australia had about 1.25 rheumatologists per 100,000 population.

“[To reach the benchmark by 2033], basically we need to double the number of rheumatology advanced training positions,” Professor Hill told the limbic in Hobart last Sunday ahead of her presentation.

She said that while the shortages extended across the country, the most affected areas included NSW/ACT with a shortfall of 94 rheumatologists, Queensland (75) and Victoria (73).

Professor Hill, an Adelaide-based rheumatologist, also warned an ageing workforce and a large percentage of rheumatologists planning to reduce their hours would compound supply issues, particularly in rural and regional areas.

A workforce survey conducted by the ARA indicated 38% of rheumatologists were considering reducing their hours, with 16% approaching retirement and 82% reporting they wanted to cut back their hours within the next two years.

The report [link here] developed by the ARA Workforce Needs Analysis Working Group, which included Professor Hill, was sent to stakeholders in February and, since then, the ARA has had meetings with the Federal Department of Health, as well as Department of Health representatives across the various jurisdictions.

It’s clear! We have a shortfall of rheumatologists – everywhere!#ara23 IL pic.twitter.com/CcaXwrKjex

— Australian Rheumatology Association (@AusRheum) May 9, 2023

Aside from training positions, Professor Hill also suggested initiatives to increase job satisfaction and reduce burnout might improve retention and productivity.

“Having more advanced scope nurse practitioners, more nurses and advanced scope physiotherapists might be helpful; and also reducing the administrative burden around drug applications and things like that,” she told the limbic.

“We need to look at regional positions as well because they’re mostly based in public hospitals in the city. We actually have one in private practice in Adelaide, where we take trainees out to the country and encourage country practice.”

The ARA also backed a recommendation published in the Parliamentary Inquiry into Childhood Rheumatic Diseases interim report last year [link here], which called on the Federal Government to “urgently establish an eight-year program of secure funding to provide fellowships or training programs with the aim of tripling the number of paediatric rheumatology specialists by 2030”.