What is a Rheumatologist?
This is a physician of pediatrics or internal medicine that has pursued specialized training in diseases of the bones, muscles, and joints. This specialized training commonly includes various types of arthritis, which in the United States it affects more than 46 million adults as of 2011. Two common types of arthritis are rheumatoid arthritis and osteoarthritis. In order to see a rheumatologist, the patient will be referred to them by their primary care physician.
Job Description of a Rheumatologist
As a rheumatologist, you will diagnose and treat arthritis and other similar medical conditions. You may also be involved in research to help advance the understanding of these types of medical disorders. You may also play a consulting role to a primary care physician or help manage an individual’s healthcare team. The reason that you may manage this team is to provide an interdisciplinary care approach because of the chronic nature of the patient’s medical disorder.In these individual treatment plans, you would coordinate elements like the use of certain medications, physiotherapy, and occupational therapy. Depending on the medical disease or disorder some of the medications that might be prescribed can include specialty medications that are designed just for that medical disease or disorder, steroids, non-steroidal anti-inflammatory drugs (NSAIDs), and analgesics.
You will also see patients that are referred to you by their primary care physician because the patient is presenting an ongoing or severe pain in their muscles, joints, or bones. You will often treat patients that present a wide variety of autoimmune disorders, diseases that affect your bones or joints, and systemic conditions. These can include:
- Marfan’s syndrome
- Arthritis, of which there are numerous types, more than 100
You also provide nonsurgical means of treating muscle, bone, and joint disorders. When working as a rheumatologist it will help for you to have a great deal of patience, especially if you are working as a pediatric rheumatologist because many times when children are in pain they are irritable and not very cooperative. Some children may even be developmentally disabled or preverbal. Even adults can be very irritable when they are in pain, and many appear frustrated if they feel that their treatments are not working as they feel they should. You should also have great organizational skills, good communication skills, and enjoy working with people, including patients, fellow physicians and other medical and non-medical personnel.
Other duties that you might perform can include:
- Because most patients are referrals and not just walk-ins before the patient arrives for their first appointment you will need to assess their chart to learn about their medical history. You will also need to find out what medications they are taking, what their complaints are, any tests or lab work that has been done, and anything else that pertinent to their particular case;
- Examining the patient to better access their problem and work toward a diagnosis and treatment plan. While examining, you need to pay attention to all details, even if they’re not obvious;
- Do a physical exam;
- Order and obtain lab and test results;
- Make a treatment plan;
- Prescribes medications such as steroids, anti-inflammatory medications, etc. You must know if the patient has allergies or not, before anything is prescribed;
- Setting up physical and occupational therapy sessions;
- Educating your patient and their family about how to deal with a chronic rheumatic disease;
- Go to health fairs to also educate the community on this same subject. In both instances, you may discuss topics such as coping techniques, how to improve their quality of life, different medications that can be used, how to prevent becoming physically challenged, and regaining function of their joints, bones, and muscles;
- Working with other medical personnel involved in the care of the patient such as their primary care physician, physical therapists, occupational therapists, skilled nurses, etc.
Being a rheumatologist, you will be working hand-in-hand with the patient to determine their pain level not only at the time of the appointment but at other times, what causes the pain, and what treatment is going to be done to give them hopefully long-lasting relief. You may have the patient keep a diary of the things that seem to trigger their pain and how bad it is when it is triggered when this happens, and whatever else would be helpful for you to treat their medical disease or disorder.
How to Become a Rheumatologist?
While in high school you should take as many science and math classes as you can such as general science, biology, algebra, chemistry, geometry, etc. You should also develop your writing and reading habits as they will be very helpful as you further your education. Once you own your high school diploma or its equivalent, it is time to get your undergraduate degree, which most of the time is a bachelor’s degree. The degree should be in subjects that are related to human anatomy, general sciences, medicine, and biology. It will take you 4 years to get your bachelor’s degree and during that time you need to make sure that you are maintaining a high GPA because it will give you a competitive edge to help you get into medical school.
In your last year of your undergraduate program, you can take the Medical College Admissions Test (MCAT). You want also to get a high score on this test. To get into medical school, you may also need letters of recommendation, and write an essay. Doing some volunteer work in the medical field will also help you get into medical school.
Once you have been admitted to medical school, you will have another 4 years of schooling before you can get your Doctor of Osteopathy (D.O.) or Doctor of Medicine (M.D.) degree. Through the first 2 years of medical school, you will take courses in biochemistry, anatomy, pharmacology, microbiology, medical ethics, psychology, and more. You will also learn how to check patients, diagnose diseases and medical disorders, and how to make a medical history.In the last 2 years of medical school, you will care for patients in clinics and hospitals under the supervision of experienced physicians. Throughout this time, you will do rotations in pediatrics, surgery, psychiatry, obstetrics, and gynecology, etc.
After graduating from medical school, you will need to do a 3-year residency program where you will specialize in pediatrics or internal medicine because rheumatology is a subset of these two specializations. If you want to treat children then you would choose pediatrics but if you want to treat adults it would be internal medicine. Once you have finished with your residency program, you will do a fellowship program, which can be 2 to 4 years of study in rheumatology. At the end of your fellowship, you are ready to pursue board certification and licensing. To get your certification you have to pass a rigorous examination that is conducted by the American Board of Internal Medicine. Once you are certified, you can apply for the mandatory state license in the state where you are going to practice. It is also necessary for you to attend continuing education courses and conferences to keep your certification and license. Attending these conferences and courses you can monitor the advances in the practice of rheumatology. You can also learn about any new approaches to the various medical conditions you treat.
Work Environment and Schedule
Most rheumatologists will work in their own private practice or group practice, outpatient facilities, hospitals, and medical clinics. You will work in a well-lit, temperature controlled, medically sterile environment. Most spend their days seeing patients, ordering tests such as laboratory tests like blood tests, x-rays, MRI, or CAT scan, dictating or entering what they have done or ordered for that patient during the visit, etc. Depending on the extent of the visit you may see 10 or more patients a day. Most are scheduled for a 30-minute visit or consultation but can be longer. It depends on why they are seeing the rheumatologist. Most will work full time but not a normal 40-hour week but more like 60 hours a week. Depending on their work environment they may be on-call 24/7.
Pros and Cons of Being a Rheumatologist
As mentioned, a rheumatologist is a physician who works with patients who have joint, muscle, or bone diseases or disorders. It can be a very fulfilling career with a salary over 6 figures but is it worth it to go through all those years of education. Considering the number of years of education if you start your journey after high school you are still going to be in your 30s before you can begin to practice. Let us see what other pros and cons we can think of in the career of a rheumatologist.
- 6-figure salary even in an entry-level position unless you start your career working in the hospital where the average yearly salary for an entry-level position is $78,611. The opportunities to earn a living and more than just the average living are great. You will have financial stability and you can easily pay off your loans, and buy the house and the car you’ve always wanted.
- If you are a people person and love to try to make people feel better, this is the career choice for you. It is also a good skill to have, and you should naturally be able to do that. Not everyone would make a stranger happy or feel better, but if you have it in you then even patients will benefit from dealing with you.
- Can have your own private practice or work in a group practice. In other words, you are free to choose whatever you consider to be better for your career.
- Many years of education equal large student loans to pay back. However, on the plus side, you will have your big-enough salary to help achieving that.
- Can work weekends and also be on-call that can wreck your social life. So, for some rheumatologists it’s hard or even impossible to establish a family, or to have a social life which goes beyond the people you see at work. If this aspect bothers you and wouldn’t leave you in peace, then this career is definitely not for you.
- Many weeks you will work more than 60 hours. This means that you will feel tired or exhausted at times, but that doesn’t mean an excuse for not paying attention or for making mistakes. You will need to work excellently, even if you’ve worked, let’s say, 80 hours last week.
- Constantly on your feet, which is not the easiest to handle, especially during long weeks. On the plus side of this challenge, your muscles will grow and you’ll become stronger whether you wanted it or not.
- Men make more than a woman so if you are a woman you can expect to make approximately 29% or more less than a man. This is not gender discrimination, it’s just plain statistics. It doesn’t mean that it would always be like that, but chances are high that women will earn less if they work as rheumatologists.
- No chance to advance your career, so basically there’s no such thing as a career ladder here. Once you’re in, you’re in, but your position is always the same.
In 2012, the average yearly salary was $184,659 according to the U.S. Bureau of Labor Statistics (BLS) but what the exact salary is will depend on your geographical location, working environment, years of experience, and gender. Yes, it is true; men make more than women rheumatologist does. For example, in 2012, the average annual salary for a man was $191,000 while a woman earned $149,000, which averages out to 29% less even though they both do the same job.
Three years ago the best average annual salary was found in the North Central region of the United States, including Kansas, the Dakotas, Nebraska, and Iowa at $216,000 and the Southwest offered the least at $141,000. In the field of rheumatology, according to the U.S. Department of Labor reports that only 15% of all physicians special in internal medicine and of those that do very few specialize in rheumatology. Although no growth rate is predicted this bit of information tells you that the field rheumatology is the field that will need the most physicians and that this is a great field to get into. As people age, those who specialized in internal medicine are going to be seeing more elderly patients who are suffering from various bone, joint, and muscle disorders, especially bone and joint disorders.According to the BLS, the highest paid annual salary was $378,000 while the lowest was $179,000.
In addition to the great entry-level annual salary, there is also the benefits package.If you are in private or group practice you will have benefits but you will also supply benefits to your employees.Some of the general benefits that you can receive include:
- Paid vacation and sick days
- Paid holidays but if you have to work the pay could be double time
- Profit sharing
- Bonuses paid quarterly or annually
- Long and short term disability
- Life and medical insurance that can include the family and may include vision/dental coverage
- Malpractice insurance
- If on-call, you may be reimbursed for your cell phone
- Continuing education reimbursement
- Paid travel expenses when going to seminars and conferences
Salary of a Rheumatologist in 2016
In 2016, the average annual entry-level position was $119,000 but the average annual salary was $257,855, which is up almost $70,000 from 2012 when the average annual salary was $184, 659.If it has increased that much in just 4 years, you can only see the salary increasing in the next few years.
Rheumatologist Salary in Canada, Australia and UK
In Canada, the average year-long salary for a rheumatologist was C$130,000 and in Australia the average annual salary was AU$152,000 to AU$205,000.
In the United Kingdom, the average annual salary is based on the age of the rheumatologist.If you are youthful, in your 20s, you can earn up to £75,000 and in your 30s it is up to £98,000.By the time you are in your 40s and 50s, you can earn up to £116,000.
Conclusion on Rheumatologist Salary
As mentioned very few physicians choose to go into internal medicine and even less choose rheumatology as a sub-specialty so in order to attract future physicians to specialize in internal medicine or pediatrics as a rheumatologist they are going to have to offer an enticing salary. In addition to the shortage of rheumatologists, there is also a gap between what a man and woman makes for doing the same job. This is also going to have to be fixed to make the pay equal in order to get more physicians to specialize in rheumatology.It is a fast paced job that requires you to have great organizational skills and great communication skills. In addition to the wage, there is also the great benefits package but you also have to consider the expenses. There are payments such as rent, salary for your employees, utilities, etc. you are going to pay if you have a private practice or are a part of a group practice, so this is going to cut your profits.