My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…
It is a great honor to serve you as the 80th president of the American College of Rheumatology (ACR). The ACR is a leader in the world of rheumatology. Therefore, with this privilege also comes enormous responsibility. A Brief History of the ACR The first efforts to study and control the rheumatic diseases in the…
A storm has been brewing down the street from my office. It is a David & Goliath dispute, pitting young children and their families against a renowned pediatric institution, Boston Children’s Hospital. It concerns the fate of a half-acre swath of green space, the Prouty Garden, replete with meandering paths, fountains and a towering redwood…
At the 2016 ACR/ARHP Annual Meeting in Washington, D.C., in November, the ACR and the ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. In the November 2016 issue, we reported on the ARHP’s awards. This month, we speak with the ACR winners. Presidential Gold…
Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…
When treating adolescent patients who are making the important, sometimes bumpy crossing from a pediatric to an adult rheumatology practice, there’s no one-size-fits-all approach. “We have to be flexible on the receiving end when talking with these patients, and flexible with their families, too,” says Peter A. Nigrovic, MD, director of the Center for Adults…
Pediatric rheumatology was formally recognized as a specialty in 1991 by the American Board of Pediatrics. Prior to this time, children with rheumatic diseases were treated by a hodgepodge of providers. In addition to providers who had training as pediatric rheumatologists, general pediatricians, adult rheumatologists, allergist-immunologists, orthopedists, pediatric infectious disease specialists and others treated children…
I read the 2015 ACR Workforce Study Report with great interest as one who served on the 2005 Manpower Taskforce.1,2 I found it disappointing that the deficit in rheumatologist FTEs that we predicted a decade ago has become a fact. Of even greater concern, the strategies we proposed to address this problem have not been…
This past June, Yvonne Golightly, PT, MS, PhD, helped launch an international group of researchers focused on foot and ankle osteoarthritis. At the time, Dr. Golightly, an assistant professor in the department of epidemiology at the University of North Carolina (UNC), Chapel Hill, N.C., was attending the American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR)…
Nonsteroidal anti-inflammatory drugs (NSAIDs) have been used therapeutically since the 1960s.1 Evidence of adverse cardiovascular outcomes led to the withdrawal of the selective COX-2 inhibitor rofecoxib in September 2004, when the question of cardiovascular safety of NSAIDs first came into the limelight.2 Valdecoxib (Bextra) was subsequently withdrawn from the market in April 2005 due to…
The ACR’s Affiliate Society Council (ASC) membership has grown from 34 states to 40 since 2015. The growth of the Council is mainly attributed to newly formed state societies, as well as existing state societies focusing on orienting themselves for advocacy on behalf of rheumatologists and their patients. Increased participation by state societies helps support…
On Nov. 12, nearly 150 supporters of the Rheumatology Research Foundation gathered at the St. Regis Washington, D.C., for the Donors of Merit recognition dinner. This annual event honors those who contributed to the Foundation throughout the year. Foundation President Eric Matteson, MD, MPH, applauded leaders who have played an essential role in the Foundation’s success….
“Burnout? In rheumatology fellowship? You’re kidding me, right?” That was the response of one of my very good friends from residency who is now a cardiology fellow, when I told him that I was concerned that one of my co-fellows, at another institution, was on the verge of burning out. Stepping back, I could understand…
Our elected officials make decisions every day that affect our lives and the lives of our patients. These decisions are often based on input they have received from advocates and lobbyists, constituents and fellow lawmakers. Regardless of our ideals, money plays a role in this decision making, because political contributions facilitate access to legislators and…
To be an effective practice owner, it is necessary to understand the financial circumstances and environment of the practice’s operation. Well-managed practices prevent the loss of time and money. Therefore, to improve productivity and operating efficiencies, you need to have a basic understanding of billing and payment initiatives that will impact the practice’s bottom line….
A 38-year-old female patient returns to the practice for the second of three hyaluronate sodium injections of the left knee. The patient states the pain is somewhat better after her last injection. Her weight is 165 lbs., her height is 5 feet 6 inches, and her blood pressure is 120/81. After discussing the risks of…
Take the challenge. D—As of January 2015, there are three new codes added to the arthrocentesis codes of 20600–20611. The new codes, 20604, 20606 and 20611, should be reported when the procedure is performed with ultrasound guidance and CPT 76942 should not be billed separately. The three new codes are defined as: 20604—Arthrocentesis, aspiration and/or…