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The Medical History – Pitfalls and Preferences

By recognizing the limitations of memory and patient recall, I tend to focus historic elements that have high predictive value and avoid time consuming worm-holes in history-taking that have low predictive value. This leaves me with more time to listen to the patient.

Best of 2017: Rules for Drug Cessation with Infection

Everyone gets their education about drug-related infection risk from television ads. Rheumatologists should know what the real risks are and educate their patients that they have a higher than normal rate of nonserious infections. But the infection risk is way more related to inflammation than any specific drug risk.

Best of 2017: The Retiring Rheumatologist

Just last week, I went to a doctor’s retirement party. It was festive, with honors and ribbing for the lucky one, but there was an asterisk to his milestone. Retirement was not anticipated or planned for. What is your retirement plan?

Death of the Dinner Meeting

Many years ago, rheumatologists would assemble with lunar regularity to discuss cases, journal articles or listen to a great visiting speaker or leader in rheumatology. While many of these meetings occurred at a local eatery, they were more about the meeting than the eating.

How to Present an Abstract at EULAR

Good News!  Your research submission has been accepted for presentation at a national congress (i.e., ACR or EULAR).  This is often a first step in the lifetime of a project – Abstract, Presentation, Full Write-up and Publication.  Instead of being enthralled or overwhelmed with the notion of doing your first abstract, review my approach to creating, presenting and reviewing abstracts for a major medical meeting.

The Gender Gap in Rheumatology Leaders

Leadership positions in medicine are disproportionately filled by men. Although the enrollment of medical schools are equal male: female or even some have more women, 40% of American medical institutions lack programs for recruiting women, or for retention and promotion of female faculty.

This may also be true in rheumatology, which is now attracting more women than men as trainees. I recently wrote an article in the Lancet about mentoring women in medicine and suggested ideas for improving the gender gap in leadership.  

A Busted Valise

Just because it’s busted, it doesn’t mean you have to fix it.  At some point, it’s important to know when to leave “good-enough” alone. Such is the story of the "busted valise" and what to do about it.

It Begins with the Introduction

The introduction of a guest or speaker should be simple, functional and respectful. In the least, it should go something like, “I have the honor of introducing our speaker, Dr. John Brown, who comes to us from Brown University, where he is the Chief of Internal Medicine. Today he’s going to lecture on “the right way to lecture”. 

However, no one does this. Instead most try to do more, usually with knowledge gaps, and end up delivering incomplete, awkward or bad introductions.   

Introductions tend to either be awkward or great.  

A Rheumatologist’s “Quality of Life”

I tell my patient’s that I empathize with them. I understand that they do not want a rheumatologic condition, nor do they want to take our medications and are disheartened when I tell them that we have no cures. But, if we flip that proverbial coin over, my goal for their care is to improve their quality of life.In rheumatology, we have many ways to accomplish that goal for our patients; from medication management to advocacy and support groups for patients and loved ones. But what are you doing at work or home to improve YOUR quality of life and the lives of those around you?

Sexist Rheumatology

Cush and Dao are at it again. This time it's whether men or women are better patients. Cush says men are better patients; Dao says Er, not so fast bub!  This is their light-hearted, gender biased debate on the best patients: Men vs. Women.

Throw Me Rope

A gal with rheumatoid arthritis moved to my town and has transferred her care to me. Despite having RA for 3 years and swollen joints at the last three visits, she has taken surprisingly few effective drugs thus far.

On this visit I declared my concerns for her future health, especially if we didn’t make significant changes in therapy. So I recommended she start a new drug. She asked several good questions, then stated she wanted to go home and think about this further and she would get back to me with her decision.

But wait, that’s what she said at her last visit 2 months ago!  

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