Wednesday, 21 Nov 2018

Blog

The Gender Gap in Rheumatology Leaders

Leadership positions in medicine are disproportionately filled by men. Although the enrollment of medical schools are equal male: female or even some have more women, 40% of American medical institutions lack programs for recruiting women, or for retention and promotion of female faculty.

This may also be true in rheumatology, which is now attracting more women than men as trainees. I recently wrote an article in the Lancet about mentoring women in medicine and suggested ideas for improving the gender gap in leadership.  

A Busted Valise

Just because it’s busted, it doesn’t mean you have to fix it.  At some point, it’s important to know when to leave “good-enough” alone. Such is the story of the "busted valise" and what to do about it.

RheumNow Celebrates Three Years

Three years ago we published our first edition of RheumNow. We have something - and someone - to celebrate. Surprise, Dr. Jack Cush - this one’s for you! 

Everyone wonders how he does it. Vision. Drive. Determination. Unwavering resolve. Strength of purpose. Commitment - day in, day out. Willing to take risks. Unwilling to settle. All these, yes, but also this: passion, heart and soul.

In celebration, we asked a few of his colleagues to share their remarks about this important milestone. Without further ado…

It Begins with the Introduction

The introduction of a guest or speaker should be simple, functional and respectful. In the least, it should go something like, “I have the honor of introducing our speaker, Dr. John Brown, who comes to us from Brown University, where he is the Chief of Internal Medicine. Today he’s going to lecture on “the right way to lecture”. 

However, no one does this. Instead most try to do more, usually with knowledge gaps, and end up delivering incomplete, awkward or bad introductions.   

Introductions tend to either be awkward or great.  

A Rheumatologist’s “Quality of Life”

I tell my patient’s that I empathize with them. I understand that they do not want a rheumatologic condition, nor do they want to take our medications and are disheartened when I tell them that we have no cures. But, if we flip that proverbial coin over, my goal for their care is to improve their quality of life.

In rheumatology, we have many ways to accomplish that goal for our patients; from medication management to advocacy and support groups for patients and loved ones. But what are you doing at work or home to improve YOUR quality of life and the lives of those around you?

Sexist Rheumatology

jjcush

Cush and Dao are at it again. This time it's whether men or women are better patients. Cush says men are better patients; Dao says Er, not so fast bub!  This is their light-hearted, gender biased debate on the best patients: Men vs. Women.

Throw Me Rope

A gal with rheumatoid arthritis moved to my town and has transferred her care to me. Despite having RA for 3 years and swollen joints at the last three visits, she has taken surprisingly few effective drugs thus far.

On this visit I declared my concerns for her future health, especially if we didn’t make significant changes in therapy. So I recommended she start a new drug. She asked several good questions, then stated she wanted to go home and think about this further and she would get back to me with her decision.

But wait, that’s what she said at her last visit 2 months ago!  

The Delayed Diagnosis of Spondyloarthritis

You see them from the corner of your eye, standing with a kyphosis in the waiting room. They are filling out their paperwork, standing up because sitting is just not pleasant. You are the rheumatologist with an  interest in ankylosing spondylitis (AS) and spondyloarthritis, so more likely than not, the patient with the bent spine is going to be your next new patient. In the back of your mind you are hoping that they are not so far along so that the therapy you may prescribe can make a difference in their life.

A Least Favored Patient

Sasha D just doesn’t like me.  I’ve seen her four times in the clinic, and each visit was a tense battle of misunderstandings, with both of us leaving dissatisfied or worse. The failing wasn’t in the diagnosis, but rather the malalignment of our goals and inability to listen. Despite my efforts, my words, the diagnoses and treatment suggestions haven’t been well received.  

The Board Certification Tango

Recently, I was invited to apply for an open seat on the American Board of Internal Medicine (ABIM), the large organization that certifies physicians in the United States. Part of the process is to write a personal statement on my views of the ABIM mission and what I would like to accomplish. 

 

What Does Your Desk Say About You?

I’m a firm believer that your desk space is a window to your soul, if not your neuroses. 

My first year fellow and colleague kept his desk meticulously sterile. It was so sparsely decorated and clean, he could be the poster child for minimalism. This was in drastic contrast to our program director, who had papers and books strewn about and multiple half-filled coffee cups surrounding his desk. His chair was typically found in the middle of the room with his white coat thrown about like a kindergartener’s art project. 

Here are my observations from the natural habitats and home-base of rheumatologists.  

The Millennial Doctor- Mighty or Mediocre?

A 3rd year medical student started his rotation with me this past week and the rotation was a challenge for us both.