Specialists in juvenile arthritis start at Children's
Published: Wednesday, September 12, 2007, 8:07 AM Updated: Wednesday, September 12, 2007, 9:04 AM
Drs. Randy Cron and Tim Beukelman are celebrities in certain health care circles in Birmingham and Alabama.
The pediatric rheumatologists moved from Children's Hospital of Philadelphia to Birmingham in August after being heavily recruited by the University of Alabama at Birmingham and Children's Hospital.
They are attempting to fill a large void. For the past five years, Alabama has been without a specialist trained to treat children with arthritis, lupus and other rheumatic diseases. A sole pediatric rheumatologist practiced for two years at Children's Hospital, but left in 2002.
Cron and Beukelman are holding their first clinics this week and were booked weeks in advance. Their schedule is already overloaded for the next few months.
Specialists trained to treat children's illnesses that affect the joints, muscles, bones, connective tissues or blood vessels are in scarce supply nationally. Recruiting Cron and Beukelman was a project several years in the making. The Arthritis Foundation raised $1 million and UAB contributed $500,000 toward the endowment of a chair in pediatric rheumatology at the medical school.
Children's Hospital just completed a $2.8 million outpatient clinic on Fourth Avenue South to treat rheumatology patients, along with children who have diabetes or other endocrine problems, and allergy and immunology patients.
Four-year-old Delaney Casselman of Chelsea and her family raised about $2,000 through lemonade sales for the Arthritis Foundation. Delaney has had juvenile rheumatoid arthritis since she was 2 and has gone to Atlanta for treatment.
When her family met Beukelman at an arthritis camp earlier this summer, Delaney's mother almost cried.
"We have so prayed for you, forever," Jennifer Casselman told Beukelman.
Delaney has an appointment to see Beukelman today, his first day in clinic.
"We are so excited," the mother said. "She has never been in remission. I want to see what new ideas these doctors have."
Despite the heavy patient demand, Cron and Beukelman will see patients in clinic only one day a week each. Both have academic appointments at UAB and will spend the rest of their time researching and teaching. Cron, who holds the Arthritis Foundation Alabama Chapter Endowed Chair in Pediatric Rheumatology, said he hopes to be able to recruit another pediatric rheumatologist each year for the next three to four years.
"It's going to be a work in progress," Cron said. "What we have now is better than nothing, but it's not going to solve the problem overnight."
Cron said he and Beukelman hope to build the program so that UAB can start a fellowship program for training other pediatric rheumatologists. The Arthritis Foundation is continuing to raise money to support that effort.
Part of the shortage comes from poor reimbursement. The specialists are not well paid compared to the amount of training required.
"Pediatric rheumatology reimbursement is extremely low because mostly what we do is think," Cron said. "You don't get paid to think in medicine. You get paid well if you poke things into people and do procedures."
Cron and Beukelman were both being recruited by other places. Big draws to come here included the collaboration among the Arthritis Foundation, UAB and Children's, and the national reputation of UAB's adult rheumatology program, which includes five endowed chairs in immunology and rheumatology.
The doctors also got the chance to help design a new clinic tailored to their needs. Children's Hospital architects reworked the clinic's initial plans after the specialists said they would like an infusion lab to treat patients who need medicine administered intravenously.
"I knew they were serious about us when they did that," Cron said.