Rheuminations: Imagine a Better World for Clinicians & Our Patients

While these dreams are inspiring, they are also daunting. To make them feel achievable, I’ve broken them into smaller, more manageable dreams within dreams for 2025. Here they are:

• I dream that I learn at least one profound thing from my patient per encounter. Each patient brings a unique perspective, a lived experience that goes beyond a journal article or textbook chapter. By actively listening and engaging, I hope to not only improve the quality of their care but also deepen my understanding of what it means to live with that rheumatologic disease. This dream reminds me that growth as a clinician comes from humility and curiosity.
• I dream that the rheumatology community remains united in the face of an unprecedented workforce crisis: the growing shortage of rheumatologists is a challenge that threatens patient access and care quality. As a community, we have to remain united and advocate for policies to support our workforce and replenish our ranks. That means that we take our dreams to Washington, D.C., and our state capitals and communicate our dreams clearly with our public servants.
• I dream that our patients have access to high-quality information for self-management and self-care. Empowering patients with knowledge is key to improving outcomes, but high-quality, accessible information in this post-truth era is often hard to find. I dream of a world in which authentic, approachable, and applicable information is available at our patients’ fingertips. It’s only through the realization of that dream that patients can take an active role in managing their health.

Dreams can seem ethereal and fantastical, but they are very much real, and they play important roles dictating the way that we see reality. They are part of mutualistic processes that link our inner mind to the outer world. By learning how to dream more effectively—in both the literal and the figurative senses, we remake ourselves and the world around us on our own terms. Alternatively, if we ignore our natural capacity to dream, we surrender ourselves and our world to the dreams of others, and that is a recipe for a nightmare.

Admittedly, the dream of this rheumatologist, in which joint pain and immune dysfunction are relegated to historic time periods, remains lofty. Yet I’ll hold that dream close to my heart in order to guide my thoughts and actions through this year and this century.

Bharat Kumar, MD, MME, FACP, FAAAAI, RhMSUS, is the director of the rheumatology fellowship training program at the University of Iowa, Iowa City, and the physician editor of The Rheumatologist. Follow him on X (formerly Twitter) @BharatKumarMD.