Blogs
My Nurse Practitioner
My NP is not only a great nurse, counselor, rheumatologist, complex disease manager, joint injector, diabetes expert, clinic leader, mother, wife, and friend – she’s the go to person if you’re a patient, coworker, colleague, cousin or neighbor. She is one of few great partnerships in my entire career. To go to battle with a NP at my side gives me a tremendous daily advantage.
Piece of My Mind
You know so much, and they have too much to learn, but limited time and few opportunities make it difficult to share information and fill that gap - especially in a way that will “stick” and be meaningful to the patient. When tempted to give patients 'a piece of my mind', here are some things to consider.
Time for a Paradigm Change in Rheumatoid Arthritis
How many clues are needed for a rheumatologist to know something is wrong with the therapeutic soup he/she is trying to concoct? One patient's tale leads to rethinking the RA treatment paradigm.
TIPS for Arthritis Travelers
Travel can be challenging for arthritis patients. Here are some useful tips to travel smoothly and pain free.
The Brooklyn HAQ
The Health Assessment Questionnaire is a utilitarian outcome measure, often used in clinical trials and daily practice. Unless you’re still prescribing penacillamine, never attended an ACR meeting, and never read an RA clinical trial, you’re quite familiar with the HAQ and its use in practice. So, surely you’ve heard of the “Brooklyn HAQ”?
I Got a Hug Today
It was at the end of the visit with the patient I've only seen three or four times for her osteoarthritis, carpal tunnel syndrome and back pain.
Take the Patient's Call
I recognized the tone in his voice. I recognized the clipped words and the unmistakable undertone of bother and dismay. I recognized them because I have had the same tone, the same clipped speech and latent frustration in my voice: and now I was on the receiving end of this undercurrent of impatience. It took my recent stint as a patient to make me realize how important the call from the patient can be.
Morning Stiffness Madness
Rheumatologists distinguish themselves from their medical colleagues in several ways: exceptional joint exam and joint injection skills, interpretation of complex immunologic findings and cost-efficient ways of managing common musculoskeletal disorders. But what’s the one trait, skill or question that defines the acumen of the rheumatologist? Please don’t say morning stiffness.
Listen to the Patient…She’s Telling You the Diagnosis
I had a 20-minute visit scheduled with Mrs. Goldstein yesterday. She is a thin, foreign-born, older woman with rheumatoid arthritis, recently complicated by lymphoma. As I sat, I asked “where is your husband this morning”, as he usually attends her medical visits. I had already turned to the computer and started to bring up her file, meds, etc. There was a long pause before she finally answered.
Improving Drug Safety Communications
pWhat do you call it when you say one thing and the listener hears something else? Potential answers would include hard of hearing, parenting or the physician-patient relationship.
The Errors that Underlie 'Medical Errors' in the News
Upon reading the title of a recent news item - 'Medical error is the third leading cause of death in the US' - a feeling of apprehension and dread arose. Very quickly, my worst fears were realized.
Biologic Prescribing and Patient Education
Biologics are big. Their popularity is reflected in their growing use since being introduced in 1998. Biologics have been used by more than 3 million patients worldwide. In 2013, Enbrel, Remicade and Humira accounted for nearly $30 billion in worldwide sales. In the USA, it is estimated that we will spend $220 billion on biologics by 2017.
What It’s Like to Work with a KOL (Key Opinion Leader)
Rheumatology is fortunate to have many "key opinion leaders" (KOLs) to teach, study, synthesize and pave the advances in our discipline. Who are these KOLs and how can we tell them apart?
Why Not Just Kick the TNFi Habit?
Why do we use TNF inhibitors as our first biologic choice? Is it the evidence of efficacy, access, safety, and drug retention, or is it a prescriber habit that merits critique?
