Arthritis is a disabling and painful disease that affects 50 million Americans, including 300,000 children.  Nearly 1 in 250 children are living with a form of arthritis. Juvenile arthritis is one of the most common childhood diseases, affecting more children than cystic fibrosis and muscular dystrophy.  Currently, there are less than 250 board certified, practicing pediatric rheumatologists in the United States and about 90 percent of those are clustered in and around large cities.  Pediatric rheumatology has one of the smallest numbers of doctors of any pediatric subspecialty.  Of those children with juvenile arthritis, only one-fourth see a pediatric rheumatologist due to their scarcity.  The other 75% of juvenile arthritis patients see either pediatricians (who tend not to be trained in how to adequately care for juvenile arthritis) or adult rheumatologists, who aren't trained to deal with pediatric issues, whether it’s the stunted bone growth that can result from arthritis and its treatment, or the unwillingness of an adolescent to take his medicine.  Furthermore, the diseases that are common in children can be very rare in adults, so a rheumatologist may have rarely, if ever, had occasion to diagnose and/or treat those related diseases and co-morbidities.  There are currently eleven states that do not have a single practicing pediatric rheumatologist and seven states with only one pediatric rheumatologist.

Pediatric Subspecialty Loan Repayment Program:

The pediatric subspecialty loan repayment program was authorized by Section 5203 of the Affordable Care Act (ACA) in March 2010. The program, which would be administered by the Health Resources and Services Administration (HRSA), would incentivize training and practice in pediatric medical subspecialties, like pediatric rheumatology, in underserved areas across the United States. The program would offer up to $35,000 in loan forgiveness for each year of service for a maximum of three years.  The program was authorized for $30 million for FY 2010 through FY 2014, but has yet to be appropriated any funding. 

President Obama requested, in FY 2013 budget, $5 million dollars to fund the Pediatric Subspecialty Loan Repayment Program.

What Your Members of Congress Can Do to Act on this Issue:

To  help alleviate the current shortage of pediatric rheumatologists in the United States, the Arthritis Foundation urges Congress to appropriate $5 million to fund the Pediatric Subspecialty Loan Repayment Program in FY 2014. 

What You Can Do to Act on This Issue:

• Watch Kristen’s Story, a powerful video created by the Arthritis Foundation’s Southeast Region, to learn more about the shortage of pediatric rheumatologists in America and the impact it has on patient access to care, disease management, and a childhood.

• Share this map that demonstrates the critical need for more pediatric rheumatologists in the United States

• Share this issue brief with your family, friends and community leaders

• Share this Arthritis Foundation letter with your Member of Congress.
• Download a joint letter submitted by the Arthritis Foundation and the American College of Rheumatology to the Appropriations Subcommittee on Labor, Health and Human Services requesting their support for this program.