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From: The Rheumatologist, September 2011
Features
Meet the Challenge of Primary CNS Vasculitis
Diagnosis and treatment of this rare and poorly understood condition
A 64-year-old previously healthy man was admitted to the hospital with a 1.5-month history of severe headache, confusion, personality change, and progressive cognitive decline. He had no previous medical problems. Results of the physical examination showed ataxia. The mental status exam revealed impairment of cognitive functions. Laboratory test findings were unremarkable. The erythrocyte sedimentation rate was 2 mm/hour. Tests with normal or negative findings included serum antinuclear antibodies,...
How to Incorporate Learners in Your Clinic
Let your time with residents provide training opportunities, not undermine efficiency
“The resident’s purpose is to entertain the patient until I can get there,” I said decisively, suppressing a smile as I awaited the audience’s reaction. I was attending our Department of Medicine’s inaugural “Teach the Teachers” faculty development workshop held last June on a hot summer afternoon. The sun was shining, but we were in a drab and dark classroom. At this workshop, we were discussing outpatient teaching when a colleague asked, “How do you...
ACR Launches First Public Relations Campaign
Simple tasks campaign targets lawmakers, referring physicians and others who influence rheumatology
Inflammatory rheumatic diseases, with arthritis, cause more disability in the United States than heart disease, cancer, or diabetes. One in 12 women and one in 20 men will develop a rheumatic disease in their lifetime. These diseases often strike in the prime of life and can cause joint and organ destruction, severe pain, disability, and even death.
A&R Abstracts: CNS Vasculitis
For Further Reading
Want to know more about vasculitis in the nervous system? Check out these abstracts from Arthritis & Rheumatism, and log on to www.wileyonlinelibrary.com/journal/arthritis to read the full articles.
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News
It's Not Just EHRs Anymore
Patient-centered information technology is an increasingly popular way to help manage complex diseases
While only a healthcare provider is actively encouraged to interface with an electronic health record (EHR), patients of all kinds—and rheumatology patients in particular—are increasingly getting the chance to participate in their care using all things electronic: pads, portals, kiosks, and phones to make an appointment, renew a prescription, participate in research, or see a doctor remotely. The technological blue sky, it seems, is no longer the limit.
What You Need to Know about ACOs
Rheumatologists may need to speak up to get a place in these new healthcare groups
Accountable care organizations (ACOs) have taken a prominent position in the healthcare reform movement as part of cost-saving strategies. But in the 2011 National Physicians Survey conducted by HCPlexus and Thomson Reuters, a full 45% of the nearly 3,000 participating physicians said they did not know what an ACO was.
Rheumatologists Share International Honor
Two rheumatologists receive prize for significant research discoveries
Two rheumatologists were awarded the 2011 Carol Nachman Prize for Rheumatology this June in Wiesbaden, Germany. The highest international honor for rheumatology-related research, the prestigious award acknowledges excellence and innovation in clinical, therapeutic, and experimental studies in rheumatology.
Essential Evidence Plus
Tools and Alerts for Clinicians Who Deliver First-Contact Care
Massage Improves Function in Patients with Chronic Low Back Pain; Vertebroplasty Marginally Better Than Usual Care for Compression Fx (Vertos II); The Evidence Base for CAM in Children is Insufficient; Mobile Phone Texting Helps Smokers Quit
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From the College
Meaningful Use and Patient Engagement - Supporting eHealth Literacy
It is no surprise that understanding health information and navigating the U.S. health system can overwhelm even the savviest patients with advanced literacy skills. Data from the National Adult Literacy Survey suggest that nearly 50% of all adults have problems understanding many aspects of healthcare, including prescriptions, appointment slips, and health education materials.
Networking Opportunities Abound
Networking opportunities can make a large educational conference experience feel truly meaningful, memorable, and beneficial. Make your annual meeting experience memorable by participating in networking options that appeal to you.
ACR Member Named PPAC Physician Researcher of the Year
Captain Lisa Rider, MD, a physician-scientist and clinical researcher at the National Institute of Environmental Health Sciences in Bethesda, Md., was named 2011 Physician Researcher of the Year by the Physicians Professional Advisory Committee of the United States Public Health Service. The award was presented in recognition of her basic and clinical research into myositis. Her recent research findings have included: definitions of improvement as a primary composite endpoint for myositis clinical trials,...
Researcher Looks for Clues to Help Treat Pediatric Lupus
With the support of the ACR Research and Education Foundation (REF) Awards and Grants program, Ornella Rullo, MD, has developed research that may help rheumatologists better treat pediatric patients.
The Role of the Physician Assistant in the Treatment of Pain
Pain is a common manifestation of rheumatic conditions. Patients with rheumatic diseases such as rheumatoid arthritis, lupus, gout, and osteoarthritis require disease-specific management for controlling acute episodes of pain as well as strategies to control ongoing daily discomfort.
ACR Talks to Congress about Physician Payment Reform
This year, key congressional committees that oversee healthcare have held hearings on the flawed Sustainable Growth Rate (SGR) formula and are discussing various payment reform options. The ACR has submitted testimony to the key committees encouraging Congress to:
Coding Corner!
September’s Coding Challenge
A 46-year-old male patient with osteoarthritis in his right knee comes in for a routine follow-up office visit. The patient had an intraarticular corticosteroid injection in his right knee six weeks ago with reported improvement in knee pain and stiffness. The patient reports stiffness in the knee lasting 5 to 10 minutes after long car rides and in the morning one to two times per week. He reports mild knee pain when climbing stairs. The patient has no other complaints and no comorbidities. He is currently...
Coding Corner Answer
September’s Coding Answer
Coding and Billing Guidelines Overview and Resources
Due to federal regulations and the variety of audits that now exist, the ACR has developed an overview of guidelines and identified a list of resources to keep handy to ensure all current guidelines are strictly followed.
Practice Page
Practice management changes and opportunities in 2012
Managing an efficient practice requires seamless and transparent protocols. Key federal and governmental agencies are targeting risk areas in physician practices to reduce compliance risks and healthcare fraud. While some of the new requirements starting in 2012 initially represent changes with office operations and cost, especially for system upgrades, ultimately the goal is to facilitate quality patient care, proper documentation, provide incentives, and increase productivity.
more From the College
Departments
Ethics Forum
The ethics of ultrasound
This month we will consider the potential ethical pitfalls of costly new technology—and we want your help. Tell us how you would address this ethical dilemma by e-mailing dantoline@wiley.com.
Drug Updates
Information on new approvals and medication safety
The new maximum daily dose (MDD) of acetaminophen will soon be six dosage units (3,000 mg) for all Tylenol and acetaminophen-containing products, a reduction from the current MDD of eight dosage units (4,000 mg), says McNeil Consumer Healthcare of Johnson & Johnson.1 The MDD lowering recommendations are intended to reduce accidental overdoses from over-the-counter acetaminophen-containing products. In January, the U.S. Food and Drug Administration (FDA) asked manufacturers of prescription products to...
Rheum with a View
Panush’s perspectives on selections from the literature
Palliative care in rheumatology is not an oxymoron or concession of failure. I thought about this subject after a recent rheumatology conference. The topic was “new therapies for systemic sclerosis.” One of our fellows presented a nice distillation of some of the new studies. The therapeutic targets (endothelin, phosphodiesterase, platelets, combinations of these, platelet-derived growth factor, and vascular endothelial growth factor) reflected evolving thinking about the important events in...
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Columns
I Will Be the Squeaky Wheel
Being the voice of rheumatology is critical to improving care for our patients
On the walls of my examining rooms, I have the ACR flyer forewarning visitors about the decreased access Medicare patients will have to rheumatologists, other physicians, and a variety of medical services if the sustainable growth rate (SGR) is not modified by the end of 2011. The interest in this flyer has only intensified in the past few weeks as patients have raised concerns about the debt ceiling talks and what is going to happen with Medicare. One of my elderly female patients explained that she...
Braving a Volcano (and Other Dangers) for EULAR
Conquering natural disasters and the ExCel to experience global rheumatology
If someone had said that, while I was editor of The Rheumatologist, I would write about my escape from a volcano, I would have said that he was crazy. Volcanoes are very rare events and cause trouble in either distant parts of the world or during ancient times. Durham, N.C., is not Pompeii, and there are no tumultuous eruptions around here (except when Duke wins the NCAA championship in basketball). Nevertheless, in 2010, Eyjafjallajökull up in Iceland (a distant part of the world) blew its top. It...
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Viewpoints
Letters
Feedback from our readers
“No” to More MTX; T2T and the DAS; Autoimmune versus Infection; High Cost, but Is There No Benefit?
