[Quo vadis rheumatology care in Germany? New figures on specialists as of 31.12.2024].

BACKGROUND

The number and scope of work of rheumatology specialists are crucial for the care of patients with inflammatory rheumatic diseases. We report on current developments in numbers of rheumatologists up to 2024.

METHODS

The number of internal medicine specialists in rheumatology is reported by age group, gender, field of activity, and scope of activity based on medical statistics from the German Medical Association (BÄK), the Federal Register of Physicians of the National Association of Statutory Health Insurance Physicians (KBV), basic data from hospitals, and extrapolated to the population figures of the Federal Statistical Office.

RESULTS

As of 31 December 2024, there were 1161 practicing rheumatology specialists, of whom 531 (46%) were female and 386 (33%) were aged 60 or older. The number and proportion of rheumatologists under the age of 60 fell from 806 (73%) in 2020 to 775 (67%) in 2024. A total of 725 rheumatologists were accredited to work in outpatient practices for national health insurance patients. Of these, 301 (42%) were employed, an increase compared with 2020 (148 [30%]). In contrast, the number of licensed rheumatologists fell from 392 (57%) to 365 (50%). For every 100,000 adults in Germany, there were 1.7 practicing rheumatologists, 1.0 of whom was accredited to outpatient contracted care, with regional variations ranging from 0.8 in Saarland to 1.6 in Brandenburg and Hamburg (persons, not full-time employees). Since 2018, the number of rheumatologists in hospitals has risen from 360 to 386 in 2023; part-time employment increased from 25% to 39%. The annual average number of full-time inpatient staff has fallen from 340 to 312. Between 2020 and 2024, a total of 303 new rheumatology specialists were recognized, corresponding to an average of 61 specialists per year.

CONCLUSION

The decline in the number of younger rheumatology specialists, coupled with an increase in part-time work, is leading to a decrease in rheumatology capacity in Germany. The current rate of further training is not sufficient to compensate for the age-related retirement of rheumatologists, let alone the loss of full-time positions.