I have been listening to The Fighter Pilot Podcast because my fantasy career would have been to fly a jet fighter plane (not even remotely possible, given my constitution). I learned that when an aircraft accident occurs, a mishap board is convened, not to assign blame but to try to learn what went wrong and…
Exploring the Role of Artificial Intelligence in Rheumatology
I looked at the joints. They spoke back to me—”I need more humanism,” they whispered. To longtime readers, those two sentences may sound both familiar and alien, perhaps even a little humorous. That’s because those sentences were generated entirely by a computer using artificial intelligence (AI). It was simple, too: I just copied the text…
Speak Out Rheum: Racism’s Impact on Patient-Provider Relationships
“I tell everyone who comes into her room now, ‘You will not disrespect my daughter again. No one will,’” recounts Sarah’s mother. “Every time a [provider] acts rude to her, Sarah tells me, ‘Ma, I’m used to it now,’ and I have to insist ‘No! Baby, you should never get used to that.’ … Dr….
Clinical Academic Rheumatology Generates Profits for Health Systems
Rheumatologists should be better compensated, in part, due to the revenue they bring to the hospital system from their procedures, argue D’Anna et al., who found that clinical academic rheumatologists bring significant downstream revenue to the healthcare system.
September Updates from the ACR Insurance Subcommittee
In recent months, the ISC has engaged with payers to reduce administrative burden on practices and continues to advocate to the CMS for the use of complex administration codes for biologics.
With Deepest Gratitude: The ACR Appreciates Your Willing Service
We at the ACR acknowledge all ACR, ARP and Rheumatology Research Foundation volunteers whose committee terms are ending in November. Thank you for your valuable time and efforts toward advancing rheumatology during a challenging time. ACR: Board of Directors Kenneth G. Saag, MD, MSc; ACR President Barbara Slusher, MSW, PA-C; ARP President Anne R. Bass,…
Psoriatic Arthritis & the Obese Patient
Estimates from the National Psoriasis Foundation indicate that more than 8 million people in the U.S. suffer from psoriasis and that approximately 30% of those individuals develop psoriatic arthritis (PsA).1 Given these statistics, roughly 2.4 million people in the country are likely affected by PsA. Moreover, patients with this systemic condition carry a higher-than-average burden…
The 2022 ARP President’s & Merit Awards
During ACR Convergence 2022 in early November, the ACR and the ARP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. This month, The Rheumatologist profiles the recipients of the ARP President’s and Merit Awards. ARP PRESIDENT’S AWARDS The ARP president can choose to honor ACR/ARP…
ACR Honors Distinguished Fellows at ACR Convergence 2022
Editor’s note: This has been extended from the print version to include additional background information on each recipient. Each year, the ACR honors up to 10 clinical and research fellows who have performed meritoriously. Meet this year’s Distinguished Fellows, who are bridging the gap between research and patient care, and who were recognized at ACR…
ACR Proposes New ICD-10 Code to Capture ‘Pre-RA’
On Sept. 13, the ACR and Kevin D. Deane, MD, PhD, presented a proposal to create a new clinical code to recognize a condition in which an individual may exhibit rheumatoid arthritis-related autoantibodies without clinical presentation.
Speak Out Rheum: To Prescribe Is Humane (Unless You’re In Texas)
You are a rheumatologist in Texas. You are very well trained. Your mentors included some of the leaders in rheumatology, and you are respected by your colleagues and your patients. You know the devastation of untreated rheumatoid arthritis and lupus. A young woman with recent onset of systemic lupus erythematosus is your new patient. You…
When Rheumatic Disease May Have Affected the Course of Western Civilization
The study of rheumatology (and medicine) in art, history, literature and music is engaging and informative.1-12 In this article, we present some instances when rheumatic and autoimmune diseases in certain individuals may have affected the course of history in Western civilization. Physicians are usually concerned, appropriately, with the effects of illness on the lives of…
Advocacy Highlights & Fall Treats: Reflections from the GAC Chair
Outgoing Government Affairs Committee Chair Blair Solow, MD, offers advocacy updates from 2022 and seasonal reflections on how to stay focused on efforts that matter when faced with daunting challenges.
Ongoing Advocacy Efforts Seek Use of Complex Administration Codes for Biologics
Ongoing ACR advocacy efforts are working to keep biologic drugs accessible to rheumatology patients, defending the ability of rheumatology practices to use the complex chemotherapy codes for administration of biologic therapies.
3 AC&R Study Summaries: MoCA Screening in SLE, Pediatric Social Disadvantages & Surgical Weight Loss Interventions
MoCA as a Screening Test in SLE Assessing the utility of the Montreal Cognitive Assessment (MoCA) By Oshrat E. Tayer-Shifman, MD, Kimberley Yuen, BSc, MD, & Zahi Touma, MD, PhD, FACP, FACR Why was this study done? Cognitive impairment is a common manifestation of systemic lupus erythematosus (SLE), with a prevalence of 40% based on…
The Pediatric Rheumatology Workforce: Too Many Kids, Too Few Providers
“Fifty percent of kids with rheumatic disease are taken care of by adult providers,” says Jay J. Mehta, MD, MS, attending physician and fellowship program director, Department of Rheumatology, Children’s Hospital of Philadelphia, and a co-author of the ACR’s recent pediatric workforce shortage study.1,2 “But adult rheumatologists may not have specific training in the rheumatic…
Bangalore House Call: A Patient’s Story
On a highway traversed by cement trucks and Beetle-Bug auto-rickshaws we travel north from Bangalore, India, for a house call. It is 2007, and the city leaves us grudgingly. Between fields of loose chocolate soil and sprigs of beans poking skyward, the skeletons of homes and businesses rise; armies of workers lay brick from wooden…
A Primer on Imaging in Myositis
In medicine, as in advertising, pictures can be worth a thousand words. From arthritis to vasculitis, imaging studies have been variably employed to aid in the diagnosis, treatment, risk stratification and prognostication of patients with rheumatic and musculoskeletal disorders. The same holds true with the idiopathic inflammatory myopathies (IIM), in which the clinical utility is…
Lessons from Master Clinicians: An Interview with Dr. Eric Matteson
Rheumatologists who are outstanding clinicians, provide consistently exceptional care to patients and serve as role models for colleagues and trainees are in the spotlight in our Lessons from a Master Clinician series. Here, we offer insights from clinicians who have achieved a level of distinction in the field of rheumatology. Eric L. Matteson, MD, MPH,…
Difficult-to-Treat RA Definition & Management Considerations
Despite an expanding armamentarium of disease-modifying treatments for rheumatoid arthritis (RA), some patients with RA remain symptomatic.1 Current treatment guidelines from both the ACR and the European Alliance of Associations for Rheumatology (EULAR) recommend treat-to-target strategies to achieve remission or low disease activity, and patients want to feel better.2,3 So how can we best help…
Case Report: Lupus Nephritis or a Mimic?
Syphilis, an ancient disease caused by the spirochete Treponema pallidum, has been historically referred to as the great mimicker given its heterogenous presentation. Both systemic lupus erythematosus (SLE) and syphilis can have multi-systemic involvement. Both parvovirus B19 and syphilis have been reported to cause histologic features similar to those seen in lupus nephritis. We present…
Rheumatologist Organizes Medical Mission to Ukraine
Early in 2022, a few months into the invasion of Ukraine by Russian troops, Paula Rackoff, MD, a rheumatologist and clinical associate professor at NYU Grossman School of Medicine, New York, felt an urgency to head to the region to assist the many refugees fleeing for the border with Poland. Dr. Rackoff canceled a planned…
Ethics Forum: Has the Patient Asked for More Than Can Be Ethically Allowed?
The patient, a 76-year-old woman, had very active polyarticular rheumatoid arthritis (RA), despite triple therapy with conventional synthetic disease-modifying anti-rheumatic drugs (DMARDs), low-dose corticosteroids and occasional intra-articular injections—the latter providing only transient symptomatic relief. She had elevated inflammatory markers and a 28-joint Disease Activity Score (DAS-28) score of 7.4. Because of the severity of her…
Belimumab Promising for Children with Lupus Nephritis
Belimumab is now FDA approved to treat children aged 5 years and older with active lupus nephritis, providing treatment options for pediatric patients at risk of developing renal damage.