In any practice, the physician owner and/or administrators are in charge of overseeing the responsibilities associated with human resources management. This includes employment and labor laws, government compliance issues, employee-related costs and the ever-present threat of employee litigation. The central components of human resources management include staffing the practice; staying current with the legal environment;…
Abaloparatide for Osteoporosis Abaloparatide is completing Phase III clinical trials for the potential treatment of postmenopausal osteoporosis in women who are at an increased risk of fracture.1 Abaloparatide is a synthetic peptide that engages the parathyroid hormone receptor and has favorable bone building activity. Abaloparatide has completed Phase 3 development for use as a daily…
The following summary regarding use of tacrolimus (TAC) in lupus nephritis highlights a number of debatable points. Although the role of TAC in lupus nephritis remains unproved for North American populations, it might be an excellent option in some clinical situations. These situations include lupus flare during pregnancy and also for lupus nephritis when the…
Established wisdom holds that patients with rheumatoid arthritis (RA) will fare better if their disease is diagnosed as early as possible, and treatments with disease-modifying drugs are started before inflammation can do more damage to joints and tissue. Usually, early diagnosis means spotting the clinical signs of disease, but new research tells us more about…
Many reasons exist to strive for high patient satisfaction, including those related to maintaining certification requirements, risk management, reimbursement and simply having a competitive practice, but the most important one is that by achieving high patient satisfaction, you will find that your patients will be more motivated and more engaged in their individual care, says…
Richard Meehan, MD, can still hear the distinctive sound of footsteps that would travel along a gravel path toward his wooden hut in the middle of the night in Iraq. “I’d hear somebody walk from the command post, either toward my hut or the operations officer who slept in the hut next to mine,” says…
With the chronic pain and other health issues that many rheumatology patients face every day, it’s natural for rheumatologists and their patients to wonder if cannabinoid treatments are of any help. At this point, there is insufficient evidence to recommend cannabinoid treatments to manage rheumatic diseases, according to a review article published in the May…
Are too many patients diagnosed with fibromyalgia? The co-authors of one new study believe that close to 75% of patients who have received a clinical fibromyalgia diagnosis do not meet the 2010 Preliminary American College of Rheumatology (ACR) Criteria for Fibromyalgia.1 They say these patients are false-positive and may be taking treatments they don’t need….
Scleroderma, or systemic sclerosis (SSc), is an autoimmune disease characterized by vasculopathy and fibrosis. Although relatively rare, with a prevalence in North America of approximately 300 per 1 million people, SSc is associated with significant morbidity and high rates of mortality.1 Patients with scleroderma have four times greater mortality than age- and sex-matched controls, with…
In the world of evidence-based medicine, basing diagnosis and treatment decisions on belief instead of data seems anachronistic. And yet … clinicians are human, and humans live in culture, and culture is formed by beliefs, and beliefs (consciously or unconsciously) drive perception and, often, action. So a new study shining a light on racial bias…
Obesity has an established systemic inflammatory component. Could that be a trigger for the inflammation seen in rheumatoid arthritis (RA) and other rheumatic diseases? Although there is no direct scientific evidence, both mechanistic and epidemiologic clues do give some intriguing suggestions of a possible link. “At first, we thought that fat was involved only in…
As America’s capital, Washington, D.C., maintains an outsized influence in our daily lives. Despite having a meager sliver of the New York City population, the daily political transactions that transpire in the District of Columbia impact our lives. The comings and goings in the corridors of Congress are likely to have a greater impact on us…
LONDON—New research shows that the synovial compartment appears to have a special role in the chronic nature of rheumatoid arthritis (RA), providing refuge for plasma cells and giving them an ideal environment in which to produce antibodies against citrullinated protein antigens (ACPA). The findings were presented at the Annual Congress of the European League Against…
LONDON—Research continues to advance in understanding the causes, prediction and management of the stages of early arthritis before full-blown clinical disease, and an expert highlighted some of the latest of these encouraging findings at the Annual Congress of the European League Against Rheumatism (EULAR) 2016. Many of the genetic and environmental risk factors are known,…
LONDON—Rheumatologists need to make the management of psoriatic arthritis (PsA) “a little more complex,” treating different tissues individually and doing more to help treat and prevent co-morbidities, an expert said here at the Annual Congress of the European League Against Rheumatism (EULAR) 2016. Iain McInnes, MD, PhD, director of the Research Institute for Infection, Immunity…
LONDON—Kinase inhibitors’ profile in the world of rheumatic disease therapy is growing, and they are probably going to play an even larger and more central role as time goes on, experts said at the Annual Congress of the European League Against Rheumatism (EULAR) 2016. But Gary S. Firestein, MD, director of the Clinical and Translational…
LONDON—New therapies are emerging for the two main forms of large-vessel vasculitis, giant cell arteritis (GCA) and Takayasu’s arteritis—particularly biologic therapies. But for just about every available treatment gap, drawbacks or limited evidence remain, with the results needing to be borne out in larger trials, an expert said at the Annual Congress of the European…
It’s not uncommon for a new patient to arrive at the medical offices of Alan Schenk, MD, in Laguna Woods, Calif., and immediately ask him about his musical career. In addition to being a board-certified rheumatologist for the past 32 years, Dr. Schenk is also an accomplished acoustic jazz guitarist and mandolin player. Music First “I…
From its beginnings as the Rheumatic Diseases Study Group (RDSG) in the early 1930s, NYU Langone Medical Center’s Division of Rheumatology has been built on a tradition of research and clinical care. Today’s division, with 24 full-time and 76 part-time faculty members, continues to push toward understanding the pathogenesis of rheumatic diseases and interventions to…
Heraclitus of Ephesus (c. 500 BC) is credited with the saying, “The only constant is change.” Now, centuries later, change is meteoric, and especially in healthcare and health policy, the pace of change is relentless. Rheumatology and other specialties continue to face challenges that threaten the ability to deliver compassionate, competent care to patients. The…
Brian Le, MD, a rheumatology fellow at the Medical College of Georgia at Augusta University (MCG), credits an excellent mentor and two Rheumatology Research Foundation preceptorships with guiding his career toward rheumatology. “Working with Dr. Laura Carbone has opened up a lot of doors for me,” says Dr. Le. “I wouldn’t have such a great relationship with…
Connect with colleagues at the Basic Research Conference (BRC) and the Clinical Research Conference (CRC) pre-meeting courses at the 2016 ACR/ARHP Annual Meeting! The ACR has an exceptional array of research leaders lined up for this year’s BRC and CRC sessions on Friday, Nov. 11, and Saturday, Nov. 12 in Washington, D.C. Get ready to…
The Rheumatology Research Workshop (RRW), a two-day meeting designed to promote interactions between early and established investigators to foster collaboration and facilitate career mentoring, was held this year on June 24–25 in Atlanta. Each year, the workshop includes scientific lectures, elevator pitch presentations, poster sessions and scheduled time for interaction with senior investigators to exchange…
A 55-year-old female patient returns to the office with complaints of gout pain. She is complaining of swelling and a burning pain in her left toe. She has been taking an over-the-counter NSAID to treat the pain, but this has done little to alleviate it. This is her second flare this year. The patient denies…
CPT: 99213, 89060 ICD-10: M10.072 Coding Rationale This is an established outpatient visit. The encounter is coded as 99213 because it included: History—Expanded problem-focused history. The history of present illness was brief, the review of systems was extended and the past medical and social history was documented. Examination—Detailed. There were seven organ systems examined. This…
RheumPAC is the ACR’s political action committee dedicated to increasing rheumatology’s presence on Capitol Hill. It is the only PAC dedicated to the interests of all rheumatologists and their patients. RheumPAC began in 2007 with the purpose of building contacts, influence and visibility within Washington, D.C. for rheumatology. RheumPAC works to support and elect pro-rheumatology…
Dr. Amanda King Elected President of Caribbean Association for Rheumatology The Caribbean Association for Rheumatology (CAR) elected Amanda King, MBBS(UWI), MRCP(UK), FRCP(Glas.), president during the 7th Annual CAR Scientific Meeting this summer. This year’s CAR meeting concentrated on education for general practitioners, because there are still some islands without a rheumatologist. She is the only rheumatologist…
We read the case report by Dr. Diana Girnita and colleagues (“Severe Refractory Gout: What options are left when pegloticase fails?” The Rheumatologist, August 2016) with interest. A case is reported of a subject with 20 years of chronic refractory gout who failed to respond to pegloticase therapy, and the potential roles of anti-drug antibodies or…