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Google Images is a treasure trove of photos and drawings about medicine. The pictures of RA, though, look as if nothing happened in the last 90 years: the field stagnant, gold the gold standard, biologicals never invented, ulnar deviation rampant and joint destruction inevitable. If early recognition of inflammatory disease is at the crux of modern treatment, why show end-stage disease except as a warning?
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.
Why don't rheumatologists send their smoker patients to smoking cessation programs or use aids for cessation? Do we think it is not our problem?
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.
The introduction of the 2015 rheumatoid arthritis treatment guidelines has prompted discussion and critique from many. Here's my perspective on where monotherapy and methotrexate combination therapy fits in our armamentarium.
Patients should act as if they are the CEO of a new business. Their business is the disease they must manage. The analogies of managing a business and a disease are numerous and instructive for patients and physicians alike.
We review the available literature, with a particular focus on the recent findings in the Hopkins Lupus Cohort, regarding the clinical utility of hydroxychloroquine blood levels in helping to clarify some of the issues regarding retinopathy, how best to dose this medication, and medication adherence.
Will the results of two recent large scleroderma lung studies finally inform us on how to manage interstitial lung disease in systemic sclerosis?
Our inner thoughts are usually negative, critical or pessimistic. Negative thinking is ubiquitous, and may be responsible for indecision or ill-choices. How to identify it and deal with it in patient care is an unsavory challenge often left undone.
Highlights of Rheumatology news for the week ending 20 Feb 2016.
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