People can support causes, committees, campaigns, etc. in infinite ways. Members of the ACR/ARHP can see their efforts magnified via an investment in the ACR’s political action committee, RheumPAC. Your contribution goes directly to help support rheumatology and rheumatologists around the country. Proof of any group’s success can be seen in the satisfaction of its…
Prescribing Hope: The Placebo Effect Endures
“Wait. I can explain.” One could imagine this phrase coming up under many conditions in daily life. When I first became a physician, however, I would never have expected to use this phrase in my clinic. In medical school, I was taught the importance of dialogue in establishing a relationship with a patient. Statistics indicate…
Generic-Drug Price Fixing: Is It Happening?
It started with an inhaler. Like many of you, I am a rheumatologist. And like you, I see some patients more often their own primary care provider. This is so often the case that I have gradually devolved into their backup, all-purpose doctor. I am the doc they notify when they get hospitalized for pneumonia…
Patients Lose When Insurance Company Forces Drug Switch
This past June, a 64-year-old man with a history of psoriatic arthritis and severe arthritis appeared at our clinic for his regular follow-up with concerns about a letter from his insurance company. The letter stated the company wouldn’t pay for the patient’s secukinumab (i.e., Cosentyx) prescription anymore and suggested he take ixekizumab (i.e., Taltz) instead,…
Have We Reached the Limits of Clinical Classification?
There is an old adage that there are two types of people—lumpers and splitters. For some, people are easily categorized into liberal vs. conservative, Democrat vs. Republican, Donald Trump supporter vs. Hillary Clinton supporter. For others, everyone is a snowflake, and what makes us different is much more important than what makes us the same….
The Battle with Insurance Companies to Obtain Prescriptions
If you are a news junkie, then you know that a tick-tock is a story that relies heavily on chronology, counting down the events of the day, in order, as inexorably as the ticking clock. These types of timeline stories have become very popular in the fast-paced world of modern politics, in which readers eat…
Recognizing Physician Burnout, & Tips to Fight It
4 Patients in 4 Weeks Baltimore is a little over two hours away from Richmond, Va., by car. I know this now because I recently drove to Richmond to attend a memorial service. I drove in silence. Music made me sleepy, and I could not bear to listen to another iteration of how we are…
Words Matter, from Clinical Documentation to Case Reports
Every year, my program goes through a ritual—I scrub my face, put on a smile and meet hordes of medical residents from across the country. And every year, I do my best to convince all of them that Baltimore would be an amazing place for them to complete their medical subspecialty training in rheumatology. Now…
A History of the Science, Treatment of Rheumatologic Illnesses from Gold to Gene Therapy
Mysterious Ways The juxtaposition of the old and the new was readily evident that busy Wednesday morning. My first patient, a 94-year-old gentleman, Hal, arrived with a precise request. His rheumatologist for the past 40 years had just retired, and he was searching for a doctor with expertise in the use of gold sodium aurothioglucose,…
Heated Gloves Provide Relief from Hand Pain, Dysfunction in Diffuse Systemic Sclerosis
Raynaud’s phenomenon in scleroderma or systemic sclerosis (SSc) is associated with significant discomfort and functional disability, especially in the presence of digital ulcers.1 Having lived with diffuse systemic sclerosis (dSSc) for nearly a decade, I can attest to this. It has been my experience that the hand pain and dysfunction in dSSc stems from Raynaud’s…
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