Blogs
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.
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.
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.
Polymyalgia Rheumatica: An Interval Look at Management Questions
p dir="ltr"Despite an often fairly characteristic pattern of signs and symptoms, there are significant diagnostic challenges with polymyalgia rheumatica. The reason is that similar clinical features can be also observed in other diseases mimicking PMR, including infectious and malignancies, elderly-onset rheumatoid arthritis, giant cell arteritis, chondrocalcinosis or myositis, to mention some of the most important differential diagnoses. nbsp;/p
The Brooklyn HAQ
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”?
Morning Stiffness Madness
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.
Listen to the Patient…She’s Telling You the Diagnosis
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.
KOLs Predict: What Will the Next Year Bring?
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.
Do's and Don'ts of Vaccination: a (Very) Brief Guide for Rheumatologists
The five do's and don'ts when it comes to vaccinating your patients.
Smoking and Rheumatoid Arthritis
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?
Polymyalgia Rheumatica: An Interval Look at Management Questions
p dir="ltr"Despite an often fairly characteristic pattern of signs and symptoms, there are significant diagnostic challenges with polymyalgia rheumatica. The reason is that similar clinical features can be also observed in other diseases mimicking PMR, including infectious and malignancies, elderly-onset rheumatoid arthritis, giant cell arteritis, chondrocalcinosis or myositis, to mention some of the most important differential diagnoses. nbsp;/p
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.
RA Guidelines Shouldn't Ignore the Power of Methotrexate Combo Therapy
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.
Be the CEO of Your Health
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.
