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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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
Dr. John Cush @RheumNow( View Tweet )
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.
https://t.co/rkzLwhnNYh https://t.co/bxJWptPQK9
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Dr. John Cush @RheumNow( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
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 https://t.co/3NtntmpSPV
Dr. John Cush @RheumNow( View Tweet )
Nursing Shortage Could Worsen Due to Limited Student Loans
On 11/6, a DOE rule-making committee released a new proposed framework excluding nursing from the so-called "professional degree" category -- a plan which, if finalized, would limit nurses' access to certain student https://t.co/0zpznqgdb7
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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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Dr. John Cush @RheumNow( View Tweet )
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( View Tweet )
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( View Tweet )
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( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
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
Dr. John Cush @RheumNow( View Tweet )
APP Pearls “Ensure a patient understands the weekly dosing instructions for methotrexate” - Ben Smith, DMSc, PA-C
Dr. John Cush @RheumNow( View Tweet )
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 )
APP Pearls “Steroids are not a long-term plan; AND One visit cannot fix everything” - Claudia Rivera-Salas, NP
Dr. John Cush @RheumNow( View Tweet )
Best of 2025: Variability of Guidelines on the Perioperative Use of DMARDs in Rheumatic Diseases Patients
More effective treatments in patients with rheumatic diseases have resulted in less need for major surgery, yet a substantial number of RMD patients will undergo surgery often in the setting of DMARDs use. A scoping review looked at numerous clinical practice guidelines/recommendations for the
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