Lawrence Memorial Hospital in recent months has been actively recruiting two medical specialties that local doctors have been asking for.

Besides primary care, rheumatology and endocrinology are specialties that the hospital says its coverage area needs most. The local patient population of about 100,000 requires two endocrinologists and 1.5 full-time rheumatologists, of which there are currently none in the area under age 60, said Sherri Vaughn, a family practice doctor who recruits physicians for LMH.

Endocrinologists treat patients with hormone-related diseases including diabetes, hypertension and thyroid disorders, while rheumatologists deal with painful conditions related to areas like the joints, muscles and bones.

The recruiting of the two specialties started after LMH officials began surveying local primary care doctors about medical fields they believed the market lacked.

“We repeatedly get rheumatology and endocrinology as the areas physicians would like to see in our community full time,” Vaughn said.

But Bruce Rothschild, a rheumatologist in Baldwin City, does not believe there is a need for rheumatology in the area when he’s practicing it about 15 miles outside of Lawrence.

“Rheumatology care is available, and the people of Lawrence need to know that,” he said. “I’m capable of seeing more patients.” The perceived slight could be personal in nature, Rothschild says, because he is “not a cheerleader for the hospital.”

“It makes people in the community think they don’t have access to rheumatology, which isn’t true,” he added.

Vaughn, however, says recruitment planning is long term in nature. LMH tries to be ready for possible retirements by recruiting in fields with doctors older than 60 (Rothschild says that while he is in his 60s, he has no plans to retire).

“It sometimes takes a year, two years, three years or longer to recruit a certain specialty,” she said. “When we look at areas that don’t have a huge applicant pool, you have to start looking years in advance.”

Karen Evans, a local family practice doctor, says that many of her patients live in Lawrence and prefer to stay in town for their care. She believes the specialties needed most in Lawrence are endocrinology, rheumatology and orthopedic spine surgery.

Recruiting physicians in medical specialties that see a relatively small percentage of the populace can be difficult outside of big cities, said Robert Lee, professor of health care policy and management at the Kansas University School of Medicine. “It takes a really big market to support many specialties,” he said. “The smaller the population pool you’re serving, the bigger the market has to be.”

Vaughn added that it is also hard to recruit doctors to be the sole specialist in a town where they would have no one to cover for them during time off. And since there is less demand for specialties like endocrinology and rheumatology than, say, primary care, there are that many fewer training opportunities available for medical students.