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.

Go Ahead, Jump!

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You write the prescription, hand it to the patient and explain why it’s needed, how to take it and what the most common or most dangerous side effects might be. Comprehensive, reasonable, and professional. Certainly the patient should fill the prescription and start the drug.

Eat the Frog

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My Nurse Practitioner

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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

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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

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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

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

The Brooklyn HAQ

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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

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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

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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

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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.