THE RHEUMATOLOGY GAP – Why Your Next Appointment Might Be Months Away

Article by Dr. Megan Kraus

How a growing shortage of specialists is reshaping care—and collaboration—in Kansas City

Dr. Megan Krause

La Tanya Pitts-Lipprand

Across Kansas City, a quiet healthcare gap is growing—one that many patients feel long before they understand it. For individuals living with lupus and other autoimmune diseases, access to a rheumatologist can take months. In a condition where symptoms can change week to week, that delay is more than inconvenient—it can shape outcomes.
But the story behind the shortage is not just about access. It is about what happens in the waiting.
“There are excellent rheumatologists in Kansas City,” says Dr. Megan Krause. “But we are not meeting the needs of the community. The time patients are waiting—even for follow-up care—is simply too long.”
From the patients perspective, access to care often looks like a calendar. Months between appointments. Limited time once you are finally seen. And in between, a body that does not wait.
Autoimmune diseases—especially lupus—do not follow predictable timelines. Symptoms can escalate quickly. Medications may need adjusting. New complications can arise without warning. Yet many patients find themselves managing these changes alone while waiting for their next specialist visit.

When “Complex” Means Human
In clinical settings, patients with lupus are often described as “complex.” For physicians, that reflects the reality of multi-system disease. Lupus can affect the joints, skin, kidneys, heart, and nervous system—sometimes all at once.
But for patients, the word can feel different.
“Complex” can sound like a label rather than a reflection of care needs. Many patients are not just managing one diagnosis, but multiple autoimmune conditions at the same time. What they need is not a label—but coordinated, attentive care.
Reframing this language matters. “Multi-system care” or “high-touch care” better reflects the level of attention required—and the partnership needed between patient and provider.

The Hidden Impact of Shortage
The national shortage of rheumatologists is often discussed in future terms—what might happen by 2030. In Kansas City, it is already here.
Physicians are balancing growing patient loads, limited appointment availability, and the need to prioritize urgent cases. Even when a provider wants to see a patient sooner, the schedule may not allow it.
For patients, this shows up as delayed diagnoses, long gaps between visits, and fewer opportunities to ask questions or feel supported in care decisions.
Many spend years searching for answers before ever reaching a specialist. By that time, their condition may be more advanced—and more difficult to manage.

Bridging the Gap
Despite these challenges, solutions are emerging—many rooted in collaboration.
Telehealth has become a valuable tool, especially for patients facing transportation barriers or fatigue. While it cannot replace a full physical exam, it allows for quicker check-ins, symptom monitoring, and early intervention when something changes.
Care teams are also evolving. Nurse practitioners and physician assistants are helping expand access, providing education, and supporting patients between visits. Stronger communication between primary care providers and specialists is helping ensure that testing and initial evaluations happen earlier—making specialist visits more effective.
From the patient side, education and community support are playing a critical role. When individuals have access to reliable information and support systems, they are better equipped to advocate for themselves and manage their health between appointments.

A Shared Path Forward
For someone newly diagnosed with lupus, hearing that it may take months to see a specialist can feel overwhelming. It is a moment filled with uncertainty.
But it is also where connection begins.
Across Kansas City, patients, physicians, and community organizations are working together to close the gap—building systems of support that extend beyond the exam room.

“Patients and physicians are facing the same challenge from different sides of the exam room,” says LaTanya Pitts‑Lipprand and Dr. Megan Krause. “When we work together, we can begin to build real solutions for people living with autoimmune disease.”

The future of autoimmune care will not be solved by one group alone. It will depend on partnerships, listening, adapting, and working collectively toward a shared goal.

Because the conversation is no longer just about shortage. It is about building a system where patients are supported, physicians are empowered, and access to care becomes a priority for everyone. This is why we must start the conversation. Because every conversation has the power to turn into action for lupus.

For more information or to contact
La Tanya Pitts-Lipprand
with Marlene’s Kaleidoscope, or
Dr. Megan Krause please visit mk4lupus.org