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Primary Care Rheumatology

Bruce M. Rothschild, MD
Arch Intern Med. 1982;142(1):26-27. doi:10.1001/archinte.1982.00340140028006.
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Estimations of the impact of arthritis suggest a 6% to 25% incidence in the United States.1-3 Less than 3% of afflicted individuals have ever been examined by a rheumatologist.4,5 Their treatment is usually determined by primary care physicians (family physicians, internists, pediatricians, orthopedic surgeons, and, occasionally, physiatrists). A recent national survey disclosed that 70% of physicians had little or no formal training in the management of arthritis,5 a situation virtually unchanged since 1968.6 Most current education seems to be oriented toward the multisystem disorders that form only a small part of this disease spectrum,7 with little supervised experience in evaluating the conditions of patients (history and physical examination), in mechanical and osteoarthritic diseases, and in nonmedicinal therapy.

Who should care for the arthritic patient? If the 2,000 rheumatologists in this country4.8 were full-time providers of rheumatologic care, there would still be insufficient numbers to


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