The Paradox and Value of Choice

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I’m sitting with a patient discussing moving to an advanced therapeutic (i.e., medication that costs a lot of money). I started thinking about what I would choose and given my busy lifestyle a quick injection or tablet would seem preferable to an intravenous infusion. I assume that my patients are probably like me and would make similar choices. I am a little taken aback when this patient chooses an IV medication. She tells me her rationale in terms of her feelings, ideas, fears, and expectations and it makes complete sense. I may have misjudged her and without asking may have suggested a treatment that would not have been the best for her in terms of her lifestyle or beliefs.

Food and Wine and the Rheumatologist: The Microbiome and Natural Wine

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Is the microbiome influenced by wines "terroir" (“the complete natural environment in which a particular wine is produced, including factors such as the soil, topography, and climate”)? Len Calabrese believes so.

What I'm Looking Forward to at #ACR16

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The ACR Annual Meeting (#ACR16) is such a huge event that it’s worth your time to spend an hour or two planning your time at the meeting. Here's my tentative #ACR16 session schedule.

Prescribing Hope

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Everything will be alright in the end; and if it’s not alright, then it’s not yet the end. – Suni Kapoor (from the Best Exotic Marigold Hotel)

Reboot Your Digital Self: Part Two

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Reboot Your Digital Self: Part One

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This is written as a check-up to your digital self and a wake-up call to those of you who are disconnected lazily or willfully. This is written for the journal-subscribing, big textbook toting physicians whose primary education is acquired at the medical library, weekly medical conferences or grandiose annual conventions. Before you bail out on this blog, you should recognize the consequences of not being digital.

My Take on New Ocular Screening Guidelines for Plaquenil

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A recent article published by the American Academy of Ophthalmology presented new recommendations for screening of patients being managed with hydroxychloroquine that changed the previous monitoring paradigm. More importantly, it has repositioned hydroxychloroquine from one of the safest medications that rheumatologists use to a drug that can have potentially significant ocular morbidity (if used in doses greater than 5 mg per kilogram and or for prolonged periods of time).

If You See Something, Say Something

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TIPS for Arthritis Travelers

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Travel can be challenging for arthritis patients. Here are some useful tips to travel smoothly and pain free.

Georgia Society of Rheumatology: Education Leads the Way

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Rheumatologists in Georgia and across the country are under extreme pressure to care for our patients. The Georgia Society of Rheumatology exists to stimulate interest and increase knowledge of arthritis and rheumatic diseases among physicians, allied health professionals, and lay advocates. Following are highlights of GRS issues and activities.

It's the engine that kills ya’, not the caboose

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This past weekend I was fortunate to lecture at the Harvard Advances in Rheumatology Course, where I reviewed the safety issues surrounding the use of biologic therapies. In discussing infections, cancer, cardiovascular events, etc., it became very clear to me that these problems, while worrisome, are often escalated in their importance – all at the expense of what is most dangerous: RA itself.

Florida Society of Rheumatology Annual Report

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Through educational, administrative and legislative efforts, FSR works for the betterment of rheumatology practices and patients in Florida. Here's how.