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

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

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

Go Ahead, Jump!

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.

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.

The Purse Exam: a Forgotten Part of the Physical

Should you assess your patients' “purse-onality? The purse exam is an important part of the physical that can help make the diagnosis and improve patient outcomes. I often wonder if downsizing the purse should be part of the T2T (treat to target) initiative.

MACRA for the Overwhelmed Rheumatologist

You are in good company if you find the alphabet soup of rules and regulations impacting your practice a bit overwhelming. MU, ICD10, MOC, VBM, MIPS, APM, PQRS, ACO, SGR...it’s enough to trigger fantasies of early retirement among even young rheumatologists. But don’t despair!

MONEYBALL

The movie Moneyball is a David versus Goliath tale with the A’s (David) struggling to compete with Goliath teams like the Yankees. The movie pits hunch-driven “expertise” (convention) against a mathematic approach to decision making (Moneyball). Would you trust a big Whopper computer printout of next best drug(s) to give to Mrs. Hawking who has psoriatic arthritis and needs to start a DMARD? I believe most of you would huff and scoff at a formulaic or number-driven approach.

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.

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. 

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