Although gout is one of the most effectively treated of all rheumatic diseases, it is among the worst-managed diseases long term, as shown by many studies. “Treatments are excellent, yet are dramatically under-utilized,” says Theodore Fields, MD, FACP, rheumatologist, Hospital for Special Surgery (HSS), New York. “This is because some gout patients feel better between…
Medical Paradoxes in Clinic, Lab Should Encourage Physicians to Reappraise Ideas about Health and Disease
Wash your hands. This most basic tenet of proper hygiene has been drummed into our heads for years. It’s an obvious infection prevention activity, yet for years, compliance among physicians and other caregivers has been lackluster. To rectify this matter, regulatory agencies began auditing hospital staff adherence to this axiom of infection prevention. Not only…
2015 ACR/ARHP Workforce Study of Rheumatology Specialists Predicts Future Workforce Shortfall
Ten years have elapsed since the ACR conducted its last workforce study, and we know that much has changed. The comprehensive patient-centered, integrative approach to the 2015 ACR/ARHP Workforce Study of Rheumatology Specialists in the United States (now publicly available) describes the character and composition of the current clinical workforce, recognizes demographic and employment trends,…
Electronic Medical Records Have Mixed Impact on Quality, Quantity of Healthcare
The widespread implementation of electronic medical records (EMRs) and electronic health records (EHRs) has significantly changed the quality and quantity of healthcare for both the better and the worse. The digitalization of medical records provides comprehensive documentation of all events and actions associated with an individual’s medical care. Likewise, legibility, accountability and credibility are greatly…
2016 ACR Distinguished Fellows Award Winners Discuss Early Career Contributions to Rheumatology
For they’re some very good fellows … no, seriously. They are this year’s recipients of the ACR Distinguished Fellows Awards. The Rheumatologist spoke with them about their burgeoning contributions to Advancing Rheumatology! ACR Distinguished Fellow Awards Eric Allenspach, MD, PhD Acting Assistant Professor, Seattle Children’s Hospital, Seattle Background: Dr. Allenspach seeks to understand the genetic basis…
Digital Healthcare Devices, Sensors Gaining Ground as Portable Personal Coaches
WASHINGTON, D.C.—A friendly, but stern, voice talks to Joseph Kvedar, MD, vice president of Connected Health at Partners HealthCare, from his smartphone. Dr. Kvedar has just woken up. “Good morning, Joe! Here’s the tale of the tape. Your blood pressure and cholesterol are fine. Your sleep deficit is now up to three hours for the week….
A New Approach to Fracture Prevention
Glucocorticoids are widely prescribed by rheumatologists, and the effects of daily and cumulative doses of these drugs on bone mineral density (BMD) are important elements of a draft clinical guideline document presented on Nov. 13 at the 2016 ACR/ARHP Annual Meeting in Washington, D.C. Leaders of the ACR guideline project discussed their recommendations at the…
How to Diagnose Shoulder Pain
WASHINGTON, D.C.—A 70-year-old woman had been diagnosed with rotator cuff disease three years earlier and received an array of treatments. What she hadn’t received was an X-ray. She’d had an MRI, and her doctor—not an orthopedist or a rheumatologist, but a primary care physician—had zeroed in on degenerative changes in her rotator cuff. The problem,…
MACRA: More Points, Smarter Future
As the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is implemented in January with new models for quality-based reimbursement payments, rheumatologists must seize control of how they will be paid now—and in the future. This message was stressed by speakers during Holy MACRA! How to Survive and Thrive in the Era of MACRA,…
How to Manage Patients with Giant Cell Arteritis and Polymyalgia Rheumatica
WASHINGTON, D.C.—From diagnosis questions to infection risk to treatment decisions, handling giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) comes with a range of challenges for clinicians. Speaking in the ACR Review Course at the 2016 ACR/ARHP Annual Meeting, an expert—Rebecca Manno, MD, MHS, assistant professor of medicine in rheumatology at Johns Hopkins, as well…
The ACR Government Affairs Committee’s Outgoing Chair Urges Members to Continue Advocating for Rheumatology
WASHINGTON, D.C.—Although political polarization in the U.S. has affected many people’s interest in participating in legislative and advocacy efforts that promote their concerns, William Harvey, MD, MSc, the ACR’s (immediate past) chair of the Government Affairs Committee, encouraged rheumatologists and ACR/ARHP members to remain engaged and get involved with the ACR to fight for issues…
Mesenchymal Stem Cell Therapy May Help Slow, Repair Degenerative Signs of Osteoarthritis, Musculoskeletal Disease
WASHINGTON, D.C.—For patients with osteoarthritis and other age-related musculoskeletal diseases, treatment with mesenchymal stem cells may soon offer a potent way to slow and repair degenerative signs of disease. This is the goal, a goal that is moving from the laboratory to the clinic as results from ongoing randomized clinical trials show the safety and…
Biomedical Research Key to Advancing Clinical Care for Rheumatic Diseases
WASHINGTON, D.C.—The importance of biomedical research to advancing clinical care with the ultimate goal of improving patients’ lives was on display during an ACR Discovery 2016 plenary session at the 2016 ACR/ARHP Annual Meeting. The session offered new ways to think about and treat select rheumatologic diseases, including research showing for the first time the…
Former Senator Tim Hutchinson Urges ACR Members to Advocate for Rheumatology on Local, State and Federal Levels
WASHINGTON, D.C.—“Regardless of where we are on the political spectrum, we have to get engaged,” said Sen. Tim Hutchinson, senior director, Greenberg Traurig LLP, Washington, D.C., speaking at the 2016 ACR/ARHP Annual Meeting. As a former U.S. senator from Arkansas, Sen. Hutchinson talked about the importance of members in such organizations as the ACR to…
Rheumatology Awards, Appointments and Announcements for January 2017
New Rheumatologist at Minnesota Clinic Meghan Scheibe, MD, is pleased with her new position at CentraCare Clinic Rheumatology and Infusion Services, a hospital-based practice in St. Cloud, Minn. “It’s a great practice,” says Dr. Scheibe. “Young, energetic partners and wonderful support staff. I’m seeing four to six new patients a day.” These are patients who had…
Ethics Forum: Ethical Challenges Arise for Rheumatologists Pressed to See Patients of High Social, Professional Standing Before Others
The Case You’re working in a busy rheumatology practice with wait times of two to three months for new outpatient consultations. A hospital administrator requests that his daughter see you right away. All but one of your urgent appointment slots for the week is already filled, and there are several patients on a waitlist; these…
Rheumatology Drug Updates: Giant Cell Arteritis Relapse Possible if Tocilizumab Discontinued; Plus Updates on Rituximab, Etanercept
GCA Relapse Possible When Discontinuing Tocilizumab In a Phase 2 randomized, controlled trial, tocilizumab, an anti-IL-6 biologic agent, was shown to induce and maintain remission for up to 52 weeks in patients with giant cell arteritis (GCA).1 During this trial, patients with GCA were randomized in a 2:1 ratio to receive 8 mg/kg bodyweight tocilizumab…
Charity Navigator Awards Rheumatology Research Foundation with Eighth Consecutive Four-Star Rating
Charity Navigator, America’s largest and most-used independent evaluator of charities, has awarded the Rheumatology Research Foundation with its eighth consecutive four-star rating. The prestigious ranking is the highest possible award given out by Charity Navigator and recognizes good governance, sound fiscal management and commitment to accountability and transparency. Charity Navigator President and CEO Michael Thatcher…
Infection Greater Worry Than Flare: Collaborative Guideline Offers Guidance to Prevent Joint Replacement Complications & Failure
WASHINGTON, D.C.—Total joint arthroplasty is one of the most common surgical procedures performed on adults with end-stage arthritis. One recent estimate showed that 2.5 million individuals in the U.S. are living with a total hip replacement and 4.7 million are living with knee replacements. For their patients with inflammatory arthritis, rheumatologists and orthopedic surgeons must…
How to Win the ACR Knowledge Bowl
Did you know that the ACR holds an annual Knowledge Bowl competition in conjunction with the ACR/ARHP Annual Meeting? Two fellows, along with a faculty mentor, compete in two to three rounds of trivia, modeled on the television game show Jeopardy! For the past three years I have participated, along with my team, the University…
RheumPAC Contributions Needed in 2017 to Educate Federal Policymakers about Rheumatology Concerns, Interests
2016 was an impactful year for ACR advocacy efforts. Last month we reviewed our advocacy accomplishments in 2016, accomplishments that benefited 100% of our members. However, more than 95% of ACR and ARHP members had not invested in RheumPAC by the conclusion of the 2016 ACR/ARHP Annual Meeting. Each year, many of the same dedicated…
The ACR Insurance Subcommittee Advocates for Fair Payer Policies
The ACR is committed to advocating for appropriate coverage and payment policies. The volunteer members of the Insurance Subcommittee (ISC) lead this effort by representing the ACR and its membership to the insurance industry. The ISC engages payers to ensure their policies are clinically appropriate and promote patient access to high-quality care and treatment. The…
Rheumatology Coding Question: Deconstructing Evaluation and Management Codes
A 50-year-old male patient returns to the office for a follow-up visit for a diagnosis of generalized primary osteoarthritis of multiple sites. The patient tells the medical assistant that he is experiencing sharp throbbing pain in his left hip and right and left knees. He states the pain level is 6 out of 10 and…
Rheumatology Coding Answer: Deconstructing Evaluation and Management Codes
Take the challenge. Answers: B: No—Only the treating physician can take the HPI. The medical assistant is allowed to take the review of systems. If the documentation indicates the treating physician did not take the HPI, the insurance can deny the claim as not medically necessary. B: No—If the high-risk medication is not assessed and…