The Arizona Telemedicine Program Blog

The problem

If you need to see a rheumatologist, chances are you’re going to have to wait—especially if you’re in a rural area. According to a 2013 study by the American College of Rheumatology Committee on Rheumatology Training and Workforce Issues, rheumatologists are in very short supply in the United States—and as the population ages, they are becoming even more in demand.

In addition to treating the more than 50 million Americans with arthritis, rheumatologists treat other diseases, like lupus, fibromyalgia, rheumatoid arthritis, gout and scleroderma. These specialists not only have completed four years of medical school and a three-year residency, but also have undergone an additional two to three years of training in a rheumatology fellowship.

So how do we in Arizona address this workforce issue without making patients travel long distances to be seen, often after waiting months for an appointment?

Thirty years after the invention of telepathology, the Food and Drug Administration has approved the technology for primary pathology diagnoses.

Ronald S. Weinstein, MD, founding director of the Arizona Telemedicine Program, based at the University of Arizona College of Medicine –Tucson, was chair of pathology at what is now Rush University Medical Center in Chicago in the mid-1980s when he developed his idea of diagnosing surgical pathology slides from a distance.

He has since been recognized as the “father of telepathology.”

The care continuum increasingly relies on the skilled nursing facility to extend patient care beyond the acute care facility before the patient is sent home.  The hospitals are under pressure to treat only the most acute conditions and then move the patient to facilities with lower costs of care.  Accordingly, skilled nursing facilities are accepting patients who are frailer and more complicated.  “Between 2005 and 2009, the percentage of Medicare SNF patients with eight or more co-mobidities increased from 74.8 to 86.9 percent..”  And, the “proportion of patients in SNFs categorized as having major or extreme severity of illness increased from about 45 percent in 2005 to 53 percent in 2009.”