title: Regional distribution of adult rheumatologists.
abstract: OBJECTIVE
  To analyze the distribution of rheumatology practices in the US and factors associated with that distribution, in order to better understand the supply of the rheumatology workforce.
  
  
  METHODS
  Using the American College of Rheumatology membership database, all practicing adult rheumatologist office addresses were mapped with ArcView software. The number of rheumatologists per Core Based Statistical Area (CBSA) was calculated. To investigate whether sociodemographic factors correlated with clustering of rheumatologists, covariates from the 2010 US Census for each CBSA, including age, sex, race/ethnicity, and median household income, were modeled.
  
  
  RESULTS
  Many CBSAs, predominantly smaller micropolitan areas, did not have a practicing rheumatologist. For some of these smaller micropolitan areas (with populations of at least 40,000), the closest practicing rheumatologist was more than 200 miles away. However, we also identified several more-populous areas (populations of 200,000 or more) without a practicing rheumatologist. Greater numbers of rheumatologists were more likely to practice in areas with higher population densities and higher median incomes. More rheumatologists were also found in CBSAs in which there were rheumatology training programs.
  
  
  CONCLUSIONS
  These findings demonstrate that many smaller regions of the country have no or few practicing adult rheumatologists. Patients with chronic rheumatic conditions in these areas likely have limited access to rheumatology care. Policy changes could address potential regional rheumatology workforce shortages, but limitations of the current data would need to be addressed prior to implementation of such changes.
authors.forename: John D
authors.initials: JD
authors.lastname: FitzGerald
authors.forename: Michael
authors.initials: M
authors.lastname: Battistone
authors.forename: Calvin R
authors.initials: CR
authors.lastname: Brown
authors.forename: Amy C
authors.initials: AC
authors.lastname: Cannella
authors.forename: Eliza
authors.initials: E
authors.lastname: Chakravarty
authors.forename: Allan C
authors.initials: AC
authors.lastname: Gelber
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Lozada
authors.forename: Marilynn
authors.initials: M
authors.lastname: Punaro
authors.forename: Barbara
authors.initials: B
authors.lastname: Slusher
authors.forename: Abby
authors.initials: A
authors.lastname: Abelson
authors.forename: David A
authors.initials: DA
authors.lastname: Elashoff
authors.forename: LaTanya
authors.initials: L
authors.lastname: Benford
mesh_terms: D016208:Databases, Factual; D006301:Health Services Needs and Demand; D006801:Humans; D010820:Physicians / Q000600:supply & distribution*; D012219:Rheumatology; D014481:United States; D000078329:Workforce