Every advertisement for a hospital or medical center trumpets its teams. For cancer, the team has surgeons, oncologists, radiotherapists, and many others. For arthritis, the team has rheumatologists, orthopedists, physical and occupational therapists, psychologists, and—yes—cardiologists. I am happy to have cardiologists on my team because my patients are all prone to heart disease whether by dint of their age or the debilitating effects of inflammation.
Many others have commented on the substance of the Circulation article, and I will not dwell on the nuances of COX-1 and COX-2 inhibition and whether or not naproxen is cardioprotective. My point here is that development of a scientific statement on the management of musculoskeletal pain should not be the province of one specialty—and certainly not cardiologists. Further, consultation with one rheumatologist (no matter how bright and distinguished he may be) is no substitute for collaboration—the skirmishes, tussles, and give and take—required among skilled professionals when confronting an issue as thorny and convoluted as the cardiovascular side effects of NSAIDs. Any article on the management of musculoskeletal pain needs the input of all specialties involved.
As sport coaches like to say, “There is no ‘I’ in TEAM.” I do not like to use coaches as the source of wisdom, but in this case they are right.
To my friends the cardiologists I say, you can be on my team anytime. Please remember, I should be on yours.
Dr. Pisetsky is physician editor of The Rheumatologist and professor of medicine and immunology at Duke University Medical Center.
