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Nurses - the calm through chaos

Jack Cush, MD

Gloria was the charge nurse on 3 West when a “code” was called. Action, running, and commotion ensues as the crash cart, nurses, and respiratory therapist appear at the bedside. Two residents emerge as the patient is hooked up to the monitor. While everyone assumes their position and role,

ACR Weighs in on APP Loans and Professional Degrees

ACR

The American College of Rheumatology (ACR) recently joined with 16 other healthcare organizations to submit comments to the U.S. Department of Education (ED) in response to its proposal to exclude nurses, physician assistants, physical therapists, and social workers, among other crucial

Open-access Arthralgia Clinics

Jack Cush, MD

The early diagnosis in inflammatory arthritis (IA), particularly rheumatoid arthritis (RA), hinges on efficient referral and screening of arthralgia patients. Yet most rheumatology practices are ill equipped or don't
Dr. John Cush
@RheumNow

Medicare Primary Care Shortage - betw 2013 -2021, PCPs decr 25%, while APPs rose 91%. 2021 AVAILABILITY per 10,000 Medicare beneficiaries; - Total clinicians: 23.4 to 22.2 (–5%) - Total new visits: 1162 to 1102 (–5%) - Total PCPs: 20.0 to 15.5 (–22%) - APPs: 3.4 to 6.7 (+97%) https://t.co/ALQI3O3Ian

Nurse Practitioner Independence

Jack Cush, MD

A JAMA Viewpoint article reports on a March 2025 Nurse Practitioner (NP) Entrepreneurship Summit in Boston in March 2025 identifying barriers and opportunities to NP-owned medical practices.

The 2025 Rheumatology Year in Review

Jack Cush, MD

The year 2025 presented numerous advances in rheumatology and related inflammatory and autoimmune disorders ranging from several new groundbreaking FDA approvals/indications, drug developments, game-changing guidelines and practices that will impact patient care for rheumatic diseases.

Advanced Practitioner Biologic Prescriptions for Psoriasis

Jack Cush, MD

Advanced practice clinicians (APCs; nurse practitioners and physician assistants) deliver a large share of US dermatologic care, accounting for 37% of clinicians and 27% of dermatology visits by 2020. A current JAMA Dermatology reports APC drug spending trends in dermatology, with a focus on

Dr. John Cush
@RheumNow

US News & World Report - Top 10 jobs in the USA (growth, pay, security); the only HCP listings: #5: Physician Assistant: Median salary: $133,260; Unemployment 1.6%; 33,100 new jobs by 2034 #1: Nurse Practitioner: Median salary: $129,210; Unemployment 0.6%; 128,400 new jobs by https://t.co/5c2hVc4ooi

Dr. John Cush
@RheumNow

Geisinger. Medical Center (PA) has medical staff of nearly 1,800 and another 1,200 advanced practice providers (NPs, PAs, CRNAs, midwives). They offer specialized training (eg Advanced Practitioner Fellowship in Critical Care Medicine ) and have an Advanced Practice Nursing https://t.co/pCaPWe6niB

Nursing Shortage Could Worsen Due to Limited Student Loans

MedPage Today

In November, we reported on nursing groups that pushed back against a Trump administration proposal to de-list nursing as a professional degree for purposes of student borrowing. In this report, we look ahead to see what might happen as a result of the policy change.

Dr. John Cush
@RheumNow

1 in 3 NPs and PAs switch specialties at least once in career; often without formal training in the specialty. Both "depend on MDs for mentorship and training". Hence AMA is opposed to Removing physician supervision or collaboration requirements” for nonphysician providers https://t.co/8RXL8zre0p

Dr. John Cush
@RheumNow

QD Clinic: Tophi Tales: Management of Uncontrolled Gout Daric Mueller, PA-C and Andrew Sulich, MD, St. Clair Shores, MI, present this QD Clinic: Tophi Tales: Management of Uncontrolled Gout. This QD Clinic is presented as part of RheumNow's "Mission: APP Partners in Care" https://t.co/7JTbC0223I

Dr. John Cush
@RheumNow

Assess Reproductive Health in SLE Clinic Visits Systemic Lupus Erythematosus (SLE) mainly affects women of childbearing age, increasing their risk of infertility, miscarriages, and pregnancy complications due to disease factors and medications. Rheumatologists should actively https://t.co/hqWSpqJ6HN

Dr. John Cush
@RheumNow

DPC - direct primary care offices run by nurse practitioners - states that allow independent NP practices have NPs opening DPC offices, that operate under a membership model, with pts paying for access to the office services, tests, and imaging. Over 2,300 DPC offices currently

Dr. John Cush
@RheumNow

APP Pearls “Steroids: Set a stop date upfront, educate on side effects, and teach "every milligram matters." Prevents dependence and eases tapering” - Barbara A. Slusher, MSW, PA-C, DFAAPA, DipACLM

Dr. John Cush
@RheumNow
APP Pearls “It’s okay not to “fix” the complaint right away. Validate the patient, then watch and wait when appropriate. The urge to intervene quickly without confidence can be dangerous. See the patient back, keep listening, & continue good history-taking” - Jeannette Hart PA-C
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