The rheumatology workforce in Australia: current and projected shortfalls.

Aim: To determine the status of the current rheumatology workforce and model projections for the future rheumatology workforce in Australia.

Background: The rheumatology workforce in Australia is currently facing a significant shortage. Identification of the optimal number of rheumatologists for the Australian population is challenging, and requires assessment of the current workforce.

Methods: A survey of Australian Rheumatology Association (ARA) full members was undertaken in 2021, collecting demographic data, information about type and location of rheumatology practice and other clinical and non-clinical work, work intentions and job satisfaction. Descriptive statistics and multivariable regression analyses were performed. The clinical full-time equivalent (cFTE) was estimated based on the reported number of half-days worked in clinical rheumatology practice. Using the age and gender distribution of rheumatology specialists from the Department of Health Workforce Data Tool, workforce projections were produced for the period from 2018 to 2038.

Results: A total of 81% (323/404) of full members of the ARA completed the survey. The median (interquartile range (IQR)) rheumatology clinical half-days worked/week was 6 (4-8). Adjusted to survey response, the reported clinical workload equates to the cFTE of 231 adult and 13 paediatric rheumatologists. A current shortfall of 302 adult rheumatologists and 41 paediatric rheumatologists exists relative to optimal care estimates. Furthermore, 38% of rheumatologists are considering reducing clinical hours temporarily or permanently, predominantly within the next 2 years. Based on current supply models, the shortfall will improve but will not reach optimal levels by 2038.

Conclusion: Australia has an undersupply of both adult and paediatric rheumatologists compared to optimal care ideals. An ageing workforce, many part-time, and the significant number planning to reduce hours within 2 years will exacerbate this undersupply unless the supply of rheumatologists is substantially increased.