A 53-year-old female presented to the clinic for severe polyarticular joint pain and was found to have a seronegative inflammatory arthritis. Six months before, she had completed 10 months of treatment for stage IV metastatic melanoma with the immune checkpoint inhibitors, nivolumab and ipilimumab, achieving complete remission of her cancer. She said that throughout her…
Pathologists are legendary for blending their work product with the culinary arts. Through the years, their use of delectable foods as descriptors has created a clever way to indelibly link in the minds of clinicians the histopathologic observations of disease with an assortment of these tasty foods: There is the depiction of an apple green…
May is National Arthritis Awareness Month. The ACR is committed to ensuring that arthritis and rheumatologic diseases are at the forefront of public awareness—and that better, safer treatments reach Americans in need. Fortunately, the federal government is also doing its part and has just released a major report on the national impact of arthritis. A…
The alarming statistics on prescription opioid overdoses are well known to medical professionals, thanks to the Centers for Disease Control and Prevention (CDC)’s widely cited finding that deaths from opioid analgesics have increased fourfold since 1999.1 Half of all fatal drug overdoses now involve opioids prescribed by a doctor. Meanwhile, a lack of rigorous research…
Current ARHP President Afton L. Hassett, PsyD—a clinical psychologist and an associate research scientist in the Department of Anesthesiology at the University of Michigan—attended her first ACR/ARHP Annual Meeting in 1999. Dr. Hassett submitted an abstract to the meeting describing her dissertation research exploring the role of pain and depression in rheumatoid arthritis and fibromyalgia. It…
Introduction Interest in rheumatology continues to grow, with more than 240 new adult and pediatric fellows to begin their training in the coming academic year. Given the broad and diverse career opportunities, it is an ACR goal to help guide trainees in their career decisions and professional development. Rheumatology fellowship often marks the transition from…
One day not too long ago, right smack in the middle of Thanksgiving and Christmas, I was sitting at the roundtable of our conference room, also known as the solarium due to its sunny disposition. The spirit was high, and we all felt like we could bring some joy to the clinic that day. I…
What does a new patient experience as symptoms develop and diagnosis is confirmed? Who is involved in the care of a newly diagnosed patient with rheumatoid arthritis (RA)? The ARHP Practice Committee has developed a case study that will help answer these questions . Meet Joy G., a 48-year-old woman with RA. Follow Joy through…
Ipilimumab (Yervoy) is a monoclonal antibody directed against cytotoxic T-lymphocyte antigen 4 (CTLA-4). It was the first drug to demonstrate a survival benefit in advanced melanoma and was approved by the FDA in 2011.1 By blocking the CTLA-4 receptor, ipilimumab enhances the immune response against tumors via cytotoxic T lymphocyte activation and proliferation.2 However, immunopotentiating…
“What are you?” A faculty member at the University of California, San Francisco (UCSF) School of Medicine posed this question to a resident while attending rounds. Both were portraying a scene involving micro-aggression during Differences Matter, a three-day orientation for first-year medical students. On the program’s first day, students are introduced to unconscious bias and…
Doctors have had few options to treat the chronic rheumatoid arthritis-like symptoms associated with chikungunya virus infections beyond over-the-counter pain relievers. A recent study in Science Translational Medicine has spurred new optimism by finding that a combination therapy—the anti-rheumatic drug abatacept paired with a chikungunya-neutralizing monoclonal antibody—abolished acute symptoms in infected mice.1 The strategy must…
Quality assurance and quality improvement (QA/QI) work makes sense to focus on. However, finding the time and resources for QI projects is not always easy. Until now, the business case for QI in rheumatology practice has not always been clear. However, this is changing with implementation of the Medicare Access and CHIP Reauthorization Act (MACRA)…
Often, young adults (18–23 years old) with rheumatic illness demonstrate poor adherence to treatment regimens, lack advocacy skills and have inadequate knowledge about diagnosis and treatment.1 Patients presenting at a transition clinic are typically comfortable with having their parents continue to be centrally involved with their care, but this is a time in life when…
Sirukumab Promising for RA Sirukumab, an investigational human monoclonal antibody that selectively binds to the interleukin (IL) 6 cytokine, has completed a randomized, double-blind, placebo-controlled, parallel-group, Phase 3 clinical trial (SIRROUND-T) in patients with rheumatoid arthritis (RA).1 During the trial, which took place between July 25, 2012, and Jan. 12, 2016, researchers randomized adult patients…
On many Saturday evenings, Kaleb Michaud, PhD, saves the world from pandemics, harvests barrels of coffee beans to sell at market or helps King Brandur recover the fabled Runic DragonStones. Dr. Michaud, an associate professor in the division of rheumatology and immunology at the University of Nebraska Medical Center (UNMC) in Omaha and also co-director of…
The Rheumatology Research Foundation is now offering the Innovative Research Award for Community Practitioners; tailored for physicians interested in disease investigation, it supports research ideas specific to clinical practice. The distinct perspective of clinical rheumatologists opens a window of opportunity for disease investigation that merits support for novel research. With the increasing prevalence of rheumatic…
In recent years, providers and practice groups have been worrying about Meaningful Use (MU) and gaining knowledge on using certified electronic health record (EHR) technology to avoid payment penalties, earn incentives and increase practice efficiency. Now, with the release of the final rule for MACRA payment reform, physicians will have two options for payment paths:…
An established patient is seen in the office for a scheduled visit with the rheumatologist at the start of the new year. What should the front desk staff do for all patients at the beginning of each year? Inform the patient that their co-pay is due prior to receiving treatment, and ask how they would…
Take the challenge. B—Most employer insurance plans change on Jan. 1. Because of this, it is a best practice for medical office staff to ask if there is any change to a patient’s medical coverage. Even if the patient indicates there are no changes in coverage, staff should still request to review their insurance card….
I read with pleasure the March 2017 Rheuminations (written by Simon M. Helfgott, MD), but wanted to make a small emendation. There is one other rheumatologist–Nobel Laureate besides Philip Hench. Baruch (Barry) Blumberg (1925–2011) was a bona fide rheumatologist who trained in the mid-1950s with the renowned Charles Ragan at Columbia-Presbyterian Medical Center in New…
On May 11, ACR leaders will fly to Capitol Hill to meet with Congressional leaders on behalf of ACR and ARHP members. With so many pressing policy issues facing the medical community this year, we hope that you, too, will let your members of Congress know where you stand on the following issues: Support Medical…