The year was 1991. It was my first Tuesday as a rheumatology fellow at the University of Pittsburgh’s Presbyterian Hospital. Navigating a maze of buildings and hallways, I delivered myself to the entrance to the scleroderma clinic. Running late and not knowing whether there was a separate entrance for staff, I clicked open the door….
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…
Persistent Challenges Sometimes the challenges seem neverending. In addition to the rigors of our daily lives as rheumatology health professionals—growing administrative burdens, increasing pressures to fund research and achieve balance in family and personal lives—we face a growing number of challenges related to the rapidly escalating prices of rheumatology treatments. Even more unfortunately, these costs…
The ACR Practice Management Department actively works to provide valuable, accessible resources addressing practice issues on a local and national level to rheumatologists and their staff. Our trained professionals are devoted to providing the most up-to-date tools and resources to help improve practice efficiency while meeting the myriad compliance obligations of the ever-changing healthcare landscape….
SAN DIEGO—Top researchers gathered for a review course at the start of the 2017 ACR/ARHP Annual Meeting in November to describe new research, their own treatment strategies and new ways of thinking about an array of rheumatic diseases. Here are the highlights: Raynaud’s & Other Digit Problems When a patient walks into your clinic with…
SAN DIEGO—At the 2017 Thieves Market, held Nov. 6 at the ACR/ARHP Annual Meeting, rheumatologists from around the world presented patient cases to an audience of colleagues, who then voted via text messaging to choose the cases they felt were most perplexing or intriguing. The winner received a free 2018 Annual Meeting registration, and the…
SAN DIEGO—In just two decades, precision medicine has gone from futuristic concept to realistic toolbox for clinical physicians. At the 2017 ACR Clinical Research Conference on Nov. 3, the Precision Medicine in Rheumatic Diseases: Hopes and Challenges lecture featured rheumatologists and experts on genetics, genomics, pharmacogenetics and big data who spoke about the latest research…
SAN DIEGO—At the ACR/ARHP 2017 Annual Meeting Nov. 3–8, a session on how to promote shared decision making with patients highlighted the role of the multidisciplinary professional team. And perhaps just as importantly, it noted the importance of providers recognizing their own implicit biases, which can get in the way of shared decision making. Presenters…
During the 2017 ACR/ARHP Annual Meeting, advances in biosimilar treatments were abuzz. However, many speakers noted that the presence of biosimilars on the market has not yet resulted in greater access to treatment and lower drug pricing in the U.S…
SAN DIEGO—What does cannabis offer to the treatment and management of rheumatology patients and the range of pain states they experience? What do we really know about its long-term effects? These are hard questions to answer with currently available data and a reality nuanced by complications cannabis advocates don’t always recognize, according to two experts…
SAN DIEGO—During a session at the ACR/ARHP 2017 Annual Meeting Nov. 3–8, three representatives from the federal government described several of the government’s varied national strategies and agencies that are tackling pain. All of these strategies are affected by the current national epidemic of opioid overdoses and the need for safer analgesic prescribing. But the…
SAN DIEGO—Christopher Ritchlin, MD, MPH, director of clinical immunology research at the University of Rochester Medical Center in Rochester, N.Y., travels to academic medical centers frequently to present research, and the trips give him a chance to interact with a lot of residents. When he brings up basic science, the conversation often falters. “I’ll say,…
SAN DIEGO—Rheumatologists train in quite different ways depending on their global region, said panelists at a session sponsored by the International League of Associations for Rheumatology (ILAR) held at the 2017 ACR/ARHP Annual Meeting in San Diego on Nov. 7. Four association presidents shared training disparities and efforts to bridge gaps. EULAR: Consistency Challenges The…
SAN DIEGO—The next era of rheumatoid arthritis (RA) therapy could involve combining anti-tumor necrosis factor (anti-TNF) drugs with drugs that target molecules regulating the destructive potential of synovial fibroblasts, or even with anti-angiogenic drugs, said a pioneer of RA biologics therapy at the 2017 ACR/ARHP Annual Meeting Nov. 3–8. Ravinder N. Maini, MD, professor of…
SAN DIEGO—In a roundup of current research in rheumatoid arthritis (RA) presented at the 2017 ACR/ARHP Annual Meeting Nov. 3–8, Mark C. Genovese, MD, professor of medicine in the Division of Immunology and Rheumatology at Stanford University, Palo Alto, Calif., urged his audience to reflect on the impact therapy advances have made on RA. “In…
SAN DIEGO—In Hot Topics in Myositis, a session held Nov. 7 at the 2017 ACR/ARHP Annual Meeting, rheumatologists discussed treating myositis patients in three different clinical scenarios: persistently elevated creatine kinase (CK), immune-mediated necrotizing myopathies and lung disease. Elevated CK Patients with persistently elevated levels of CK enzyme and normal muscle strength “may still have…
SAN DIEGO—An increasing number of patients is being identified with deficiency of adenosine deaminase type 2 (DADA2); fortunately, researchers and clinicians continue to better understand the genetic disease as well, experts said in a session at the 2017 ACR/ARHP Annual Meeting Nov. 3–8. The childhood-onset disease involves loss-of-function mutations to the CECR1 gene (i.e., cat…
SAN DIEGO—In his doctoral work, Sean Bendall, PhD, assistant professor of pathology and a researcher at Stanford University in Palo Alto, Calif., worked on protein identification and embryonic stem cell biology. That required examining the characteristics of cells—lots of cells. He was struck by how inefficient the process was. “The issue was, every experiment I…
SAN DIEGO—At the 2017 ACR/ARHP Annual Meeting Nov. 3–8, experts discussed improving bone health in the U.S., gave tips on bone health disorders in pediatrics and reviewed new translational science findings for joint conservation in early osteonecrosis. E. Michael Lewiecki, MD, director of the New Mexico Clinical Research & Osteoporosis Center in Albuquerque, N.M., called…
SAN DIEGO—You come to work. The day is going well. Your clinical trials are moving along. Then you get the call: It’s the Federal Drug Administration (FDA), and they’re coming to audit in about a week. You might be struck by a sense of dread. But you don’t have to be, an expert said at…
When Marc McClintock first began experiencing back pain, he chalked it up to the rigors of his racing career. For more than 36 years, Mr. McClintock has built and raced stock cars, high-powered race vehicles that compete on short oval or circular dirt or paved tracks. “I live in a commercial building, with my residence on…
With the support of its membership, the ACR publishes clinical practice guidelines in multiple disease areas based on the best available clinical and scientific data. These aim to support health professionals treating rheumatology patients to give the best possible care. Like any set of medical guidelines, ACR guidelines are based on evidence of several different…
I spent the summer between my first and second years of medical school rotating in medical weight-management clinics, boastful that I would someday be an adult gastroenterologist. I first met Melissa Mannion, MD, in the pediatric clinic; at the time, she was a second-year pediatric resident and always wore cool pants. Born a chatterbox, I…
With the aid of increasingly sophisticated neuroimaging technology, research into how the brain activates and changes in patients with chronic pain is delivering fascinating information that will hopefully pave the way to tailored, individual treatment of chronic pain. Over the past several years, data from neuroimaging studies have provided a new understanding of what occurs…
Rich Furie, MD, chief of rheumatology at Northwell Health in Long Island, N.Y., loves the ocean. At age 16, Dr. Furie inherited a summer sailing business started by his two older brothers, which Dr. Furie kept profitable for nine years. The young entrepreneurs named their fledgling company Furie Sailing, which offered sailing lessons and sailboat rentals. The…
ARHP Member Named to AOTF Board of Trustees (2018–20) Nancy A. Baker, ScD, MPH, OTR, recently took on a new role, joining the American Occupational Therapy Foundation’s (AOTF’s) Board of Trustees. The AOTF is a charitable organization with a mission to support scientific and educational programming for occupational therapy. It provides most of the grants…
On Dec. 20, 2017, Congress passed a massive tax bill that will have an impact on nearly every individual and business in America. The bill makes sweeping revisions to existing tax provisions, and it will largely affect the health industry. Individual Mandate Repealed The bill repeals the individual mandate established in 2005 by the Affordable…
Preliminary results from an ongoing study show that bimekizumab improves joint and skin symptoms in patients with psoriatic arthritis…
In the EU, certolizumab pegol has been approved for use in pregnant and nursing women with chronic rheumatic disease…
Charity Navigator, America’s largest and most-utilized independent evaluator of charities, has awarded the Rheumatology Research Foundation its ninth consecutive 4-star rating. The prestigious 4-star rating is the highest possible rating given and is based on good governance, sound fiscal management and commitment to accountability and transparency. “The Rheumatology Research Foundation is proud to receive this…
The ACR and a number of other physician medical associations are lobbying for an immediate legislative fix to a piece of the MACRA law that factors high-cost Part B drugs into a rheumatology practice’s Medicare reimbursement rate through the Merit-Based Incentive Payment System (MIPS). This change, which goes into effect immediately, will impact practices in…
A 68-year-old male patient returns to the office for his scheduled bilateral knee injections for primary osteoarthritis. The patient rates the pain in his right knee at an 8 on a scale of 10, and the pain in his left knee at a 7. He was in the office a week before, but the practice…
Take the challenge. CPT codes: 20611-LT, 20611-RT, J7326x2 or 20611, 20611-50, J7326x2 ICD-10: M17.0 Coding Rationale The CPT code 20611 is for an arthrocentesis, aspiration and/or injection, major joint or bursa (e.g., shoulder, hip, knee or subacromial bursa with ultrasound guidance, with permanent recording and reporting). The code is billed twice because this was a…