Challenges of Practicing Rheumatology in a Government Setting: A County Hospital and Veterans Affairs Hospital Perspective

Abstract

In this article, we review the challenges and opportunities afforded by working in a government setting by providing the perspective of the Veterans Affairs experience as well as the county/public hospital experience from Los Angeles County Department of Health Services. This article highlights processes and services that are unique to practicing rheumatology in a government setting, specifically, resource allocation with clinic space and staffing; protocols for access to conventional and biologic disease modifying antirheumatic drugs; and research opportunities for rheumatologists working in a government setting. Our aim is to expand the reader's understanding of this practice setting.

Keywords: County rheumatology; Public sector rheumatology; Rheumatology practice; VA rheumatology.