Marcus Snow, MD, is a rheumatologist in a multispecialty clinic in Nebraska. During the average day, the nephrologist in his clinic can assess urinary sediment. The urologist can examine semen specimens for viability. However, despite clinical training and competency, Dr. Snow and his rheumatology colleagues cannot perform synovial fluid crystal analysis for their patients. The…
Switch to Electronic Health Records Tied to Fewer Hospital Deaths
(Reuters Health)—Hospitals that switch from paper to electronic health records may eventually see lower death rates than they had before, but a U.S. study also suggests that fatalities may first increase as the transition gets underway. Researchers examined the degree of digitization and 30-day death rates for patients age 65 and older at 3,249 hospitals…

Private Practice in Rheumatology: Winners & Losers in the Workforce Numbers Game
In the U.S., the demand for rheumatologists has outpaced the supply of physicians. So how do private practices attract new physicians, and how are practices with physician vacancies managing?

How to Document the Physical Exam
The adage frequently cited in healthcare settings, “If it isn’t documented, it wasn’t done,” still rings true for the key components required in a patient’s medical record. The note in the medical record must sufficiently describe all of the services furnished to patients on a specific date. The essential requirements to appropriately bill a claim…
Coding Corner Answer: Evaluation & Management Documentation Quiz
Take the challenge. B—The presenting problem(s) is what is evaluated during the history and examination by the provider. The chief complaint is in the patient’s own words or is a follow-up for his or her current condition. The history of present illness, along with the review of systems, usually guides the provider through the examination….
Coding Corner Question: Evaluation & Management Documentation Quiz
Evaluation & Management Documentation Quiz What element drives an evaluation and management (E/M) visit? The chief complaint in the patient’s own words of why he or she is in the practice for that date of service. The presenting problem(s) being discussed with the physician for that patient during the visit. The examination performed on the…

Medical Tech-Tool Usage Is Surging
Technology in medicine is no longer new or trendy. It’s pervasive. Rheumatologists may now assume a patient has searched online for information about his or her diagnosis or potential therapies. Both physicians and rheumatology health professionals should acknowledge their patients’ Internet surfing and find out what they’ve read, says Betsy Roth-Wojcicki, RN, MS, CPNP, an…

Support Groups Can Help Rheumatic Disease Patients
Fifteen women and men seated around a conference table in a New York City hospital listen intently to one of their peers. A 40-year-old elementary school teacher shares her challenges related to the intersection of rheumatoid arthritis (RA) and the responsibilities of a demanding job.* With the support and counsel of fellow group members, the…

The Demise of the Inpatient Rheumatology Unit
Through much of the 20th century, dedicated rheumatic disease units were found in hospitals across the U.S. and countries around the world. In the latter part of the century, this began to change, with hospitals moving toward the consult model of care for rheumatic patients. This change reflects larger shifts in the medical world toward…

The Pros & Cons of Combining Different Specialties Under One Roof
Many rheumatology patients have complex conditions and require the added expertise of colleagues in other fields, such as pulmonology, neurology or dermatology. This is even more true when patients with complex care issues are referred to academic medical centers. At such centers, patients often travel hours for an appointment and see more than one provider….
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