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.
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.
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.
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.
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 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?
Dr. Jack Cush provides a perspective on the first year anniversary of RheumNow.com - a site dedicated to delivering the wisdom, art and science of Rheumatology.
A new subspecialty may emerge. New drugs will be approved (but it will be difficult for patients to get coverage for them). And an American team will win the World Series. All these and more: here are predictions for 2017 and beyond from rheumatologists across the country and around the world.
Where do your patients sit? Have you noticed they don't usually sit where you expect them to? What's up with that, and is there a psychology behind one's choice of seating? This curious observation may portend the nature of the physician-patient relationship or, at the very least, impact the layout of your next clinic.
The five do's and don'ts when it comes to vaccinating your patients.
We physicians are clearly better at defining “too sick to work” in our patients than we are for ourselves. After pondering this ill issue, I’ve come up with some wisdom, goofiness and facts.
Despite regular attendance at medical meetings and despite fulfilling regulatory requirements for our specialty, I’m not sure how much I learn that changes the way I practice medicine. So I recently persuaded a colleague to come and coach me, inviting him to observe me for a morning in clinic. This was the first time I had been observed in this way since I was a medical student. A little daunting, but after a while I largely forgot he was there. Then he gave me some feedback.