I recently came across an article in USA Today discussing a study published in the December issue of Arthritis Care & Research. The study studied data from doctor's offices and emergency rooms across the country in order to estimate the prevalence of arthritis in children.
The study found that about 300,000 kids in this country have some form of arthritis, meaning at least one of the 100 or so conditions that are grouped under the arthritis heading. Of those children, they estimate that between 50,000 and 100,000 have juvenile rheumatoid arthritis.
But what I found interesting about the article was the data related to medical visits. The researchers, from the Centers for Disease Control and Prevention, found that children with arthritis account for about 827,000 doctor visits a year. Of that 827,000, about 83,000 are emergency room visits. More distressing though were the statistics stating that the average distance parents must drive to take their children to see a specialist is about 57 miles. Also, about 15,000 kids with arthritis live in one of 11 states that have no pediatric rheumatologist, according to the Arthritis Foundation. Those 11 states are Alaska, Idaho, Maine, Montana, Nevada, New Hampshire, North Dakota, South Carolina, South Dakota, West Virginia and Wyoming. The authors of the study stated that children who do not have initial access to a specialist or a general pediatrician familiar with the many forms of arthritis often must see several doctors before being accurately diagnosed.
This made me wonder why there seems to be such a lack of specialized care for so many children. I don't have any answers, but it's probably a number of factors. Maybe it's a matter of physicians not wanting to participate in health insurance or Medicaid plans for payment reasons. It's also a well documented fact that rural areas have a hard time attracting physicians from all sorts of medical specialties. The 11 states in the article all have fairly low populations. They probably have one or more rheumatologists, but not all rheumatologists feel comfortable treating arthritis in children since the symptoms and disease progression are often so different. I once went to a rheumatologist because he was the only one listed in my county who accepted my health insurance. I knew he would probably not be a good fit for me when his office was located in a nursing home/ assisted living center. His first comment to me was that since I was 25, I should have outgrown my RA by now and shouldn't be having flares. I never went back. Instead, my internist managed my arthritis until I changed jobs and got new insurance.
Whatever the reasons, the lack of access to specialists is a major problem for many families. It means months of failed treatment or no treatment before the child may begin to find relief. In college, my career goal was to be a pediatric rheumatologist until I switched to occupational therapy. Reading this article made me feel like I should have gone to medical school after all.
Published On: December 26, 2007