Everyone gets their education about drug-related infection risk from television ads. Rheumatologists should know what the real risks are and educate their patients that they have a higher than normal rate of nonserious infections. But the infection risk is way more related to inflammation than any specific drug risk.
Busy days, overbooked patients and EMR overloads will certainly derail your day, especially if you don’t have a system to optimize efficiency. However, in your harried efforts you may overlook several simple, smart, if not crucial, tasks while seeing your next patient.
It's Monday morning and my first patient is a newly diagnosed rheumatoid. This is his first visit back after starting methotrexate 6 weeks ago. Despite doing great and in remission with only one active joint, he asks, “Are sure this is RA? Or could this be Still’s disease?” Admittedly, this is a weird second-visit question, but I was impressed.
Nearly half of all available vacation days go unused and over 40% of Americans failed to use any vacation days in 2015. Common sense says that taking more time off (not less) is likely to lead to increased work productivity. Your next vacation is essential to building a better you. Here are some tips to insure you get the most from your time off.
Just last week, I went to a doctor’s retirement party. It was festive, with honors and ribbing for the lucky one, but there was an asterisk to his milestone. Retirement was not anticipated or planned for. What is your retirement plan?
A 25 year-old female recently diagnosed with seronegative rheumatoid arthritis was started on a TNF inhibitor. She came in for a follow-up visit and noted that her toenails were brittle and discolored when she removed her nail polish recently.
Patients are labeled as having “difficult RA" when: 1) we are frustrated, 2) it's too late, 3) we've run out of options or 4) the relationship is failing. We see them, but don’t quite know what to do with them.
“It’s unbelievable how much you don’t know about the game you’ve been playing all your life.” - Mickey Mantle
This is going to be my third visit with this patient and I’m not looking forward to it.
In the first two, I discovered how sick she was and how, despite my handouts, efforts, insights and words, my educated medical expertise was totally wasted.
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