Difficult to Treat Rheumatoid Arthritis
Dr. Cush addresses the management of difficult-to-treat rheumatoid arthritis (D2TRA).
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Emergencies, Independence & Hemorrhage (1.23.2026)
Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com
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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
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2024 Cardiology Income Survey - CV APP salary has incr 15% from 2019 -23, median=$123K - 50% of APP programs lead by an APP >90% work in outpt. clinics - 2/3 of prgs deploy APPs lipid & prevention management - 2 APPs for every 3 cardiologists https://t.co/gtdm5qN1qD https://t.co/cx2JUcw4U3
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Nurse Practitioner Independence
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.
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The 2025 Rheumatology Year in Review
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.
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Advanced Practitioner Biologic Prescriptions for Psoriasis
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
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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
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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
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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.
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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
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Rheumatoid & Inflammation Testing
Master the dos and don'ts of ordering RF, CCP (ACPA), and inflammatory markers that could transform your diagnostic accuracy.
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NJ Senate (Senate Bill No. 3560) has voted to permite Physician Assistans to enter the Interstate Physician Assistant Licensure Compact, designed to streamline PA licensing to work in multiple states https://t.co/VE1DdWuFwM https://t.co/szJzShVAaz
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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
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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
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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
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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
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Comorbidity and Health Management: Tuesday Night Rheumatology Join panelists Vanessa Hill, NP-C, Lindsay Tom, PA-C, Barb Slusher, MSW, PA-C and Jack Cush, MD as they discuss comorbidity and health management in rheumatic disease. https://t.co/3KMgBW1Q4W https://t.co/4dVfKd7uy5
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Lupus Guidelines 2025 Monica Richey, ANP, New York, reviews the 2025 ACR lupus guidelines as part of RheumNow's "Mission: APP Partners in Care" campaign during the month of December. https://t.co/D1LE1H4zyi https://t.co/myPnT3ibKd
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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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Assess Reproductive Health in SLE Clinic Visits
Due to the complexity of SLE, rheumatology providers should take an active role in assessing reproductive health, providing education on how SLE may affect pregnancy, and taking a collaborative, multidisciplinary approach with the patient’s gynecologist.
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APP Pearls “It’s important to explain the difference between an overreactive immune system vs. a weakened immune system” - Miguel Rodriguez, ANP
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APP Pearls “Ensure a patient understands the weekly dosing instructions for methotrexate” - Ben Smith, DMSc, PA-C
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APP Pearls “When I’m explaining treatment options, I say “hey you are the captain of this ship, I’m your co-captain. I help to guide you along this journey… (I can help you) avoid that Hurricane.” - April Woodrow, APRN, ANP-BC
Dr. John Cush @RheumNow( View Tweet )
Emergencies, Independence & Hemorrhage (1.23.2026)
Dr. Jack Cush reviews the news and reports from the past two weeks on RheumNow.Com
Nurse Practitioner Independence
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
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
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.
Nursing Shortage Could Worsen Due to Limited Student Loans
In November, we reported on nursing groups that pushed back against a Trump administration proposal to
Assess Reproductive Health in SLE Clinic Visits
SLE predominantly affects women of childbearing age.
Three Things to Know About Hiring, Onboarding, and Training APPs
As the utilization of APPs (nurse practitioners and physician assistants) in rheumatology becomes more prevalent, here are three things to consider if you are thinking about adding an APP to your practice:
Tricks of the Trade – Clinic Advice from APPs
December 2025 is focused on advanced practice providers, their impact, education and priorities. In seeking and soliciting the help and advice of leaders in the rheumatology APP world, I have been impressed by APP pride, dedication and passion for what they do. As such, this month was
Hidden in Plain Sight: IBD
As a PA with six years of experience in rheumatology and a background in gastroenterology, today I'm discussing the clinical overlap between inflammatory arthritis—particularly psoriatic arthritis and spondyloarthropathies—and inflammatory bowel disease.
Role of the Nurse in the Care and Management of Rheumatic Diseases - EULAR Review
In 2023, a EULAR subcommittee set out to assess the roles of nurses and Advanced Practice Nurses (APN) in the care of arthritis as outlined in published EULAR guidelines. The scope of APN practices was first proposed in 2012 and revised in 2018.
5 Fractures You Don’t Want to Miss
In orthopedic practice, missing the wrong fracture can significantly alter a patient’s outcome. Certain injuries may appear subtle on initial imaging yet carry serious consequences if not promptly recognized and managed.
Reefer Madness (12.12.2025)
Dr. Jack Cush reviews the news, journal and regulatory reports from this past week on RheumNow.com. B cell drugs in SLE and ITP, biomarkers in GCA & PSS and great videos by APPs.
2025 Adult Rheumatology Fellowship Match is Strong (Again)
The American College of Rheumatology (ACR) announced today that 2025 Medicine and Pediatric Specialties Match results show rheumatology fellowship positions continuing to fill at high rates.
I Can't Believe it's Not Seronegative Rheumatoid Arthritis?!
In rheumatology, we're no stranger to uncertainty. In any diagnosis of seronegative rheumatoid arthritis, it's always our invitation to reconsider the diagnosis.
The Essential Role of Physician Assistants in Rheumatology
Physician assistants (PAs) have been integral to the delivery of healthcare since the inception of the profession in the late 1960s. The concept of the PA role evolved in an effort to solve the shortage of primary care providers in the USA.
APPs in the News (12.5.2025)
Dr. Jack Cush reviews the news and journal reports from RheumNow.com, including info on scleroderma, dermatomyositis and malignancy, rheumatologist and APP salary concerns.
Changing Loan Limits for Advance Practice Providers
The "One Big Beautiful Bill" (OBBB), or H.R. 1, was signed into law in July, calls for significant changes in the funding of healthcare education. This bill that lowers cap limits on education loans applies to graduate (APRN, PA) programs.
Long-Term APP Retention: Building Success for Practices and Providers
Advanced Practice Providers (APPs) play an increasingly vital role in rheumatology practices across the country. With rising patient volumes and a growing demand for timely, high-quality care, incorporating an APP into a rheumatology team can be transformative.
Therapeutic Updates
Underserved and Under-treated
RheumNow
Watch our Underserved and Under-Treated series as part of this month's Mission: APP Partners in Care campaign. Now available: Pain Management and Workforce & APPs
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Campaign Blogs
Campaign Videos
Podcasts
APP Podcast Series Part Two-
APP Podcast Series Part One
Comorbidity and Health Management
