Despite the innovations of new biologics and disease-modifying anti-rheumatic drugs, a large unmet need remains for patients with rheumatic autoimmune disease. Treatment remains limited for many conditions, including for conditions with a dim prognosis, such as systemic sclerosis.1 One promising treatment avenue is hematopoietic stem-cell transplantation (HSCT). Here, we provide background on HSCT for severe…
“Man may be the captain of his fate, but he is also the victim of his blood sugar.” —Wilfrid Oakley, MB BChir, an early pioneer in diabetes care Perusing the list of the most notable medical achievements in the 20th century, a reader may conclude that the discovery of insulin should rank in a category…
As medical professionals, we understand the impact quality research can have on how we care for our patients. The extensive adoption of electronic health records (EHRs) has enabled the collection of big data in rheumatology. This has provided a new and unique opportunity for the rheumatology community to conduct in-depth research into how patients are…
Editor’s note: The new Pillar Talk column is developed by the ARHP Executive Committee in an effort to share information about ongoing activities related to our four pillars: Education, Practice, Research and Advocacy. The ARHP Practice Committee is committed to addressing the current needs and evolving practice opportunities for health professionals working in rheumatology. A…
The patient was a 48-year-old woman who saw her primary care physician for a flu-like illness three months prior to admission. Her symptoms initially improved, but recurred one month later; she was treated symptomatically, and again symptoms resolved. Two months later, she presented to an outside facility’s emergency department with fever to 103ºF, with associated…
For years, guidelines from various organizations have recommended osteoporosis screening in women and men starting at a specific age or based on specific risk factors. Among these guidelines are those developed by the U.S. Preventive Services Task Force (USPSTF) that recommend universal osteoporosis screening for women 65 years of age and older and for targeted…
The words genetically modified are making people run for the hills these days. Not so when it comes to arthritis care, however. In the lab of one pioneering researcher, genetic engineering is catapulting arthritis treatment years ahead. Farshid Guilak, PhD, is a professor in the Department of Orthopaedic Surgery at Washington University, St. Louis, and…
As a manifestation of hyperuricemia, inflammatory bullous lesions have rarely been described in the past century. A more classic presentation of hyperuricemia is acute inflammatory gouty arthritis, characterized by the deposition of monosodium urate crystals. Other complications of chronic untreated hyperuricemia may include polyarticular arthritis, tophus formation and possible chronic destructive lesions of the bone,…
Physicians are no more likely than other people to want to think about what happens next. The question of who takes over for a doctor due to death, disability or retirement has legal, medical and personal implications and requires planning to ensure the succession goes smoothly. “Succession planning is like an advance directive for the…
The Osteoarthritis Research Society International (OARSI) held the 2017 OARSI World Congress in Las Vegas, April 27–30. Below, we report on two of the sessions held. Retinoic Acid & Hand Osteoarthritis Retinoic acid is a vitamin A derivative and hormonal signaling molecule with a role in cartilage and skeletal development. Retinoic acid has complex function,…
New research reinforces the hypothesis that the gut microbiome triggers mucosal and systemic immune responses in patients with rheumatoid arthritis. The research, published in Arthritis & Rheumatology May 2017, found that subgroups of patients with RA have differential immunoglobulin G (IgG) or IgA immune reactivity with Prevotella copri, an intestinal microbe that appears to be…
There you are, working steadily away on your next manuscript. The ideas are flowing. You’ve hit your stride. Nothing can stop you now—nothing, that is, except a colleague who shows up at your desk with a 20-page grant proposal. “Do you mind?” he asks. Across academia the problem is the same—too few hours in the…
Whether you’re a rheumatologist or a rheumatology health professional, unless you are self-employed, the time will come when you start thinking it may be time to ask for a raise. The thought of asking for a raise likely conjures up anything but warm and fuzzy feelings, but if you do it at the right time—and…
When it was created in 1982, the Division of Rheumatology and Immunology at the University of Nebraska Medical Center comprised one-and-a-half rheumatologists: its founder, Lynell W. Klassen, MD, MACR, and Gerald Moore, MD, who later received formal training at the NIH and now serves as senior associate dean for academic affairs. Thirty-five years later, the…
Selling a medical practice can be a lucrative endeavor. One of the most important phases of any sale transaction is the due diligence process. During this phase, a potential buyer and their advisors have the opportunity to examine the seller’s books, records and files in great detail to ensure that the buyer is comfortable purchasing…
Opana ER Pulled from U.S. Market Last month, the U.S. Food and Drug Administration (FDA) asked Endo Pharmaceuticals to remove oxymorphone hydrochloride extended release (Opana ER) from the U.S. market due to public health consequences related to abuse. The agency has concerns that the risks presented by the treatment do not outweigh its benefits.1 On…
A new measurement tool could mean big changes for the treatment of rheumatoid arthritis (RA). With funding from the Rheumatology Research Foundation, Gregg Silverman, MD, led a study that developed a means for the measurement of immunologic memory in autoimmune disease. This new tool will allow rheumatologists and investigators to measure the immunologic defects that…
Apply your skills, interests and ideas to enhance the ACR’s Continuing Assessment Review Evaluation (CARE) program. Designed for self-study at an individual’s own pace, the CARE modules provide questions on a wide range of rheumatology clinical practice topics, allowing rheumatologists to review fundamental concepts and learn important new advances in the field. Serving as a…
With a shortage of rheumatologists in the U.S. already a problem and projected to get far worse, the ACR is advocating for the passage of a variety of laws that would help narrow the gap. Legislation being fought for by ACR advocacy leaders involves streamlining visa processing for foreign physicians and promoting incentives for physicians…
The landscape of practice management and coding methodologies continues to be challenging in the current healthcare environment, and rheumatology practices must maintain focus on managing an effective and efficient practice. Join us at the 2017 ACR/ARHP Annual Meeting, Nov. 3–8 in San Diego, and gain knowledge and understanding of best practices in an ever-changing environment…
A 66-year-old woman returns to the office for a follow-up visit. She is seen by the physician assistant (PA) for her rheumatoid arthritis. She is experiencing burning pain in her right knee, and she reports that after going for her morning walk, she rates the pain at a 6 on a scale of 10. She…
Take the challenge. CPT codes: 99214-25, 20610-RT, J1030x1 Diagnoses: M05.79, M25.561 This is an established patient visit with an established diagnosis, along with a new diagnosis, which would have to be billed under the PA’s National Provider Number (NPI) and reimbursed at 85% of the fee schedule. Keep in mind that to qualify as an…