At present, the U.S. has approximately 5,000 full-time adult rheumatologists. By the year 2025, that number will decline to roughly 3,600.1 Sounds dire, right? Hold that thought. Question: What country has 99 million people and no adult rheumatologists? Answer: Ethiopia.2 The Nigerian Story And then there is Africa’s most populous country, Nigeria, with roughly 170…
Years ago, the Mayo Clinic was exploring effective ways to minimize burnout among the more than 3,000 doctors employed at its three medical and research facilities in Rochester, Minn., Scottsdale, Ariz., and Jacksonville, Fla. One strategy involved inviting physicians to participate in small groups to discuss topics that were fairly ubiquitous among doctors, from medical…
A comparison study of the serious infection burden among patients with lupus found no major differences in patients treated with three separate immunosuppressive drug regimens. Given that serious infections are among the leading causes of hospitalizations and death in patients with systemic lupus erythematosus (SLE), researchers investigated whether the incident rates differed in patients who…
When he worked for a multi-specialty practice, Jonathan M. Greer, MD, FACR, FACP, president, Arthritis and Rheumatology Associates of Palm Beach, and affiliate clinical professor of medicine, Nova Southeastern University, Boynton Beach, Fla., found that there were too many restrictions and controls and no way to enhance the revenue stream for rheumatologists. So he moved on…
The Medical Decision Making (MDM) of an evaluation and management (E/M) visit is one of the three components of determining the level of a patient’s visit. But the MDM can sometimes be the most difficult component, as this is where the provider’s thought process is quantified in deciding the correct level of E/M service. In the…
Take the challenge. CPT: 99213, 96413, 96415 x1, J1745 x 20* ICD-10: M05.09 This encounter is coded as 99213 because: History—The history of present illness is extended. The review of systems is detailed, and two of the three past, family, social history were documented, which makes the history level detailed. Exam—There are four systems examined,…
An 83-year-old established female patient who resides in a skilled nursing facility (SNF) and is diagnosed with rheumatoid arthritis with rheumatoid factor in multiple joints returns to the office for her first infliximab infusion. She denies fevers, cough, dyspnea or concurrent illness, but has joint pain and swelling in both elbows and her left wrist….
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…
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…
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…