Rheumatology’s Virtual “Water Cooler”

When availability of the pennies-per-pill drug colchicine was threatened by the branded drug Colcrys—at $5 a pill—Fairfield, Ohio–based rheumatologist Edward B. Herzig, MD, posted the news on the ACR advocacy list serve. The result? Outrage among his fellow rheumatologists and immediate action by ACR leadership, which approached the U.S. Food and Drug Administration about the issue and the impact it would have on patients with gout and familial Mediterranean fever who depended on the drug. The ACR leadership also worked with the drug’s manufacturer, URL Pharma, to provide wider coverage through the Colcrys patient assistance program.

Such is the power of a virtual community. The advocacy list serve is the most active of more than a dozen list serve communities the ACR maintains. Although it was originally developed to share ideas about advocating for issues that concern rheumatology and rheumatologists, the list serve has expanded over time, says Dr. Herzig. Today it includes discussions on a wide range of topics including electronic health records, access to treatments and medications available to patients, the politics of medicine, practice issues, the cost of drugs, and, sometimes, the philosophy of life and practice.

Sometimes the group is silent for a while, says Max Hamburger, MD, who practices in Melville, N.Y., “but then someone raises an issue, and we address it intensively.” Reading what others have to say about issues is of great value, he says. “I become aware of issues I might not have known about or overlooked and instead of my own myopic thinking, I get to see what others think. With the speed of the interaction, we all get to teach one another and learn from one another.”

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Digital Network

The sense of community the list serve provides is invaluable, note several list serve members. “Rheumatology is a fairly small fraternity,” says Chris Morris, MD, of Arthritis Associates in Kingsport, Tenn. “I have seen the list serve help us get to know each other better, so when we arrive at the annual meeting we can immediately recognize colleagues with whom we have shared discussions online.” It also provides important support, he says.