Background/Purpose: Workforce surveys are essential to plan for training, recruitment, practice management, funding, and access to care. Gender and generational differences may have significant effects on the future rheumatology workforce. The 2015 WFS provides a description of the current workforce and projected supply and demand models for 2015-2030.

Methods: Web-based surveys were distributed to U.S. rheumatology professionals and Fellow-in Training (FITs). Supply (current providers, new graduates, retirement/workload trends, practice settings) and demand (healthcare utilization, practice trends, disease prevalence, population demographics, per capita income) factors were calculated.

Results were compared with the 2005 rheumatology workforce study.

Results: The response rate was 38.5% from adults (1297/3366) and 93.4% from FITs (464/497). The supply/demand model predicts a 31% decline in clinical FTE supply from 4,997 to 3,455 by 2030, and a 138% increase in demand from 6,155 to 8,184 by 2030, generating an excess demand for 4,729 adult rheumatologists. Gender/generational effects were subsequently estimated. The current adult workforce is 59% men and 41% women. In 2015, annual patient visits were 3,133 for men and 2,249 for women  rheumatologists, compared with 2005 a decline of 14% for men and 19% for women overall and 17% for men and 35% for women rheumatologists under age 40. By 2030, women are projected to comprise 59% of the workforce. Millennials (born 1982-2004) comprise 6% of the current workforce and 50-75% of the 2030 workforce. Since 2005, there has been a reported 5% decrease per week in patient load for millennials which had a synergist effect when added to gender-generational modeling. 18% of current fellows reported planning part-time employment, 90% of whom were women. The declining clinical FTE relates to rising women/male ratio, millennials, and part-time workers.

Conclusion: The rheumatology workforce will be primarily millennial women by 2030, with the shift from a majority of men to women projected to occur between 2018 and 2020. Since women comprise the majority of part-time workers, and conduct fewer patient annual visits, this has significant implications for rheumatology supply. The millennial generation brings a higher percentage of women into the rheumatology workforce and greater emphasis on work-life balance for both sexes resulting in a predicted reduction in patient visits, clinical FTEs per rheumatologist and overall working hours. Whether millennials will continue working fewer hours throughout their careers is unknown. Women, the majority of our future workforce, are more likely to work part-time. Millennials, both men and women, see a lower patient volume at a time when demand for rheumatology FTEs will increase. The next decades bring challenges for rheumatology requiring innovative approaches to provide access to care for patients.