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Doctor’s Contracts: Pitfalls and Traps

d Kathryn H. Dao, M.D.

I have signed a few employment contracts in my career. Signing a legal document always makes me nervous. Did I forget to add something, was there something in the fine print I missed, should I have clarified a clause, what happens if I break a clause or cannot fulfill the contract obligations?

I spoke with Andrea Liberatore, JD, to navigate these questions and explain what to look for in a contract. 

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pill,pain,med,hand

Pain and Opioid Updates

d Jack Cush, MD

Today, the CDC and FDA provided new updates on the scope of pain in the USA and guidance on the use of opioids.



MMWR April 14, 2023

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computer screen safety

RA Patients on Biologics and tsDMARDs are still High Risk

d Jack Cush, MD

A new Swedish ARTIS registry study of key safety outcomes in rheumatoid arthritis (RA) patients receiving either targeted synthetic or biological disease-modifying antirheumatic drugs (b/ts DMARDs, including Janus Kinase inhibitors (JAKi)), has been updated and affirms previously held risks.

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RA,polyarticular,black,rheumatoid

Best Treatments for Immune Checkpoint Inhibitor-associated Arthritis

d Jack Cush, MD

A retrospective study of cancer patients who developed immune checkpoint inhibitor-associated inflammatory arthritis (ICI-IA) shows that biologic DMARDs were more effective than conventional synthetic DMARDs (csDMARDs) in rapid control of arthritis.

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Industry Payments to Rheums Dropped During COVID Having their clinics shut down and patients staying away during the COVID-19 pandemic was bad enough for physicians' finances, but now a new study finds that payments from industry dried up as well. https://t.co/jsxw23tTyY https://t.co/5PiaRpiSa4

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Dr. John Cush RheumNow ( View Tweet)
COVID had a significant effect on mental health of inflammatory rheumatic Dz (IRDs) pts. UK NHS survey of 639 IRD (70% RA, 16% PsA) saw 40% w/ mod/severe pandemic impact on physical & mental health; 29% w/ depression, 22% anxiety; affecting Women>males https://t.co/odUCjScMBZ https://t.co/Eb1E2In5z1

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Dr. John Cush RheumNow ( View Tweet)
Rheumatology Workforce: Is it a Women’s Issue? Dr. Rachel Tate weighs in. https://t.co/wcAtnbMu5C @uptoTate https://t.co/RU5sYABGol

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Dr. John Cush RheumNow ( View Tweet)
Retrospective of 28,360 #PsA pts saw more comorbidities by race - AAs had signif. more HTN (59% vs 52%), DM (31% vs 23%), obesity (47% vs 30%) & gout (12% vs 8%); but whites more cancer (20% vs 16%), anxiety (28% vs 23%), OP(14% vs 12%), more biologic use https://t.co/YwGjVowO3G https://t.co/3BUXFX11rh

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Dr. John Cush RheumNow ( View Tweet)
Pooled analysis of 5 RCTs of tocilizumab vs DMARDs in 4474 female #RA pts- 63% postmenopausal, 23% premenopausal, 9% perimenopausal. Perimenopausal F had less remission (HR 0.78); but exogenous Sex hormone use had higher remission (HR 1.20) https://t.co/zmvpzFlBRQ https://t.co/lUbGKr4akR

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Dr. John Cush RheumNow ( View Tweet)
Olmstead Co. population study: Clinically Isolated Aortitis (CIA) saw 8 cases over 20 yrs; incidence of 8.9 per 1,000,000over age 50 yrs. 6 of 8 were female, mean age 76yrs; all Dx @ ascending aortic aneurysm repair. Having CIA did not affect mortality. https://t.co/ruxOX4Pxg9 https://t.co/NlpF5uXWNV

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Dr. John Cush RheumNow ( View Tweet)
We developed a list of shared decision making resources that can help health care care providers and patients learn more about the process, available patient decision aids, decision coaching, and more! You can access these resources on our website here. https://t.co/t5Wua8olVA https://t.co/WdVQI72pcV

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Karine Toupin April toupinak ( View Tweet)
Predictors of RA-ILD include smoking, Dz activity, steroid use and obesity. @jeffsparks @UTSW_Rheum https://t.co/VRQc9igHWW
Dr. John Cush RheumNow ( View Tweet)
Methotrexate-induced pneumonitis (0.3% risk) is different than RA-ILD. MTX does not increase odds of RA-ILD. @jeffsparks @UTSW_Rheum https://t.co/JV1CcB0sLP
Dr. John Cush RheumNow ( View Tweet)
Japanese cohort study shows Lung cancer is more common in males w/ elder-onset dermatomyositis - risk increased by Smoking, anti-TIF1-γ-Abs and elevated MLR (monocyte to lymphocyte ratio) https://t.co/LlTkiWp7pb https://t.co/Bu9atnI8je

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Dr. John Cush RheumNow ( View Tweet)
Disease activity increases the risk of future RA-ILD. For every one point increase in DAS28, theres a 35% increase risk of RA-ILD @jeffsparks @UTSW_Rheum https://t.co/P3dNDVanuL
Dr. John Cush RheumNow ( View Tweet)
MUC5B is a common genetic variant (~12%) that is strongly assoc w/ IPF, but also RA-ILD (3.1-4.7 fold risk) @jeffsparks @UTSW_Rheum https://t.co/t1Kgmj8a3x
Dr. John Cush RheumNow ( View Tweet)
Survival in RA-ILD is reduced (data from two different eras) @jeffsparks @UTSW_Rheum https://t.co/7eGgGnEgwW
Dr. John Cush RheumNow ( View Tweet)
Risk of RA-ILD is 15% (or 1 in 6) according to Mayo clinic (Olmstead county) data. @jeffsparks https://t.co/KynitLCsK7
Dr. John Cush RheumNow ( View Tweet)
#RA with ILD portends poor outcomes, especially if seropositive. Visiting professor Dr. Jeff sparks @jeffsparks @UTSW_Rheum https://t.co/fbVyDMUm6L
Dr. John Cush RheumNow ( View Tweet)
Rheumatologist - Work-Life Survey Results Last week, registered Rheumatologists responded to an email survey regarding work-life balance. The following are the results from 190 respondents - 53% were male (47% female) and 94% were from the USA. https://t.co/2g7oL6ltAo https://t.co/uYv7sDyO9o

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Dr. John Cush RheumNow ( View Tweet)

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