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From: The Rheumatologist, December 2011


The Science of MDHAQ/RAPID3 Scores

Do patient self-reports provide valid data for evidence-based care in rheumatology practice?

Clinical decisions in RA in 1980 (and today) were based primarily on information from the patient, rather than laboratory tests, although laboratory tests were (and often remain) the only quantitative clinical information in the medical record. I have found self-reports from questionnaires provide data that are as scientifically valid as laboratory assays, and can provide key information to facilitate patient management and improve outcome.

Medical Device Safety Concerns Rheumatologists

Are recent controversies over metal-on-metal hip replacements and an IOM report cause for worry?

Over the years, there have been a number of highly publicized instances where medical devices allowed to enter the market were later found to fail at higher-than-expected rates. While rheumatologists don’t implant medical devices, they do have an interest in how these devices work--and that they work well--because they may recommend the use of prosthetic joints and other kinds of medical devices to their patients.

A Celebration of Accomplishments

ARHP recognizes health professionals for their contributions to the field

At the 2011 ACR/ARHP Annual Scientific Meeting in Chicago, the ACR and ARHP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education, and patient care. The Rheumatologist spoke with the winners about their individual contributions to advancing rheumatology. This month, we’ll meet the ARHP award winners, and in a future issue, we’ll meet the ACR winners.

Planning is Key to Meaningful Use

Practices face many challenges when adopting EHRs

Four months after signing on with a vendor for a new EHR system, Deborah Wasser is not yet ready to hit the live switch with the “cloud” service that she chose for the solo rheumatology practice of her husband, Kenneth B. Wasser, MD.

Part-Time Work

Key issues to address in your employment or independent contractor agreement

A growing number of physicians are pursuing part-time work to accommodate lifestyle demands and personal desires. According to a 2010 survey conducted by Cejka Search and the American Medical Group Management Association, 21% of physicians in the United States are working part time, compared with only 13% in 2005. Among those part-time physicians, the fastest growing categories are men approaching retirement and women in the early to middle stages of their careers. Senior physicians who are tired of a...

Road Map to Meaningful Use: Steps to get started

Here are some steps to help you get started down the road to Meaningful Use.

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“The Pisetsky Effect”* Helps Mold The Rheumatologist into a Vibrant Publication

Colleagues and contributors share thoughts as the first editor’s tenure comes to a close

If you’re a scientist who has the opportunity to do nonscience writing, it’s an unbelievable luxury,” says David S. Pisetsky, MD, PhD, professor of medicine and immunology at the Duke University Medical Center in Durham, N.C., and chief of rheumatology at the Durham VA Medical Center. A consummate scientist and physician—a dual appellation that “still gives him a thrill”—Dr. Pisetsky also relishes the writing craft, a discipline to which he has brought heart and...

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From the College

Data Rich, Information Poor

Did you know that the health information stored by your practice could be one of your most valuable assets?

Planning the ACR/ARHP Annual Scientific Meeting

As the 2011 ACR/ARHP Annual Scientific Meeting ends, those of us on the Annual Meeting Planning Committee (AMPC) take time to reflect on the process and on the product.

A Practice Manager’s Perspective on ARHP Membership

At the age of 10, Chad E. Fragle was hospitalized for Legg-Perthes disease at Texas Scottish Rite Hospital for Children in Dallas. What was a very difficult time for him and his family led to a bright and hopeful future. With the support of his family, specifically from his father, who helped start a golf tournament fundraiser to fight the disease still in existence today, Fragle was given access to administrative leaders within the hospital.

Coding Corner Question

December's Coding Challenge

A 50-year-old male patient diagnosed with ankylosing spondylitis comes to the office for a routine follow-up visit and weekly methotrexate injection. The patient reports increased low back pain and stiffness for the previous three weeks, which is interfering with his recreational activities and ability to perform household chores that require bending and lifting. The patient states he has no other musculoskeletal pain or any joint swelling. The problem-pertinent review of system is negative. He is on...

Coding Corner Answer

December's Coding Answer

Setting Goals for Future Growth

Perhaps the most personally rewarding aspect of working with the ACR Research and Education Foundation (REF) is seeing the success that can come from setting lofty goals. First and foremost, the REF is a goal-oriented organization. The staff and volunteers are not only committed to the goal of ensuring the future of rheumatology, but they aspire to reach high and to lead in this effort.

A Rheumatologist’s Dilemma—96372 vs. 96401

When coding rheumatology medical services, some coders are perplexed when it comes to coding for monoclonal antibody injections. When the American Medical Association Current Procedural Terminology (CPT) Editorial Panel updated the drug administration codes in 2006, it raised a question: What type of drugs would fall under chemotherapy administration injection?

ACR Participates in Briefing to Highlight Importance of Biomedical Research

On September 13, the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) Coalition held a congressional briefing to commemorate the 25th anniversary of the organization’s honoring of congressional champions who have been instrumental in supporting NIAMS and the NIH. The Coalition is a group of more than 70 medical, patient-advocacy, and science-based organizations (including the ACR) dedicated to advancing the critical research of the NIAMS and the NIH. The Coalition’s...

Welcome New ACR and ARHP Leaders

The ACR is pleased to welcome the newest members of the ACR board of directors and ARHP executive committee. These new members were confirmed in November during the 2011 ACR/ARHP Annual Scientific Meeting. Over the next two issues of “From the College,” you will be introduced to these new members and learn what they want to gain from their experience as new board and executive committee members.

Practice Pearls: Final Countdown for Version 5010!

10, 9, 8, 7, 6 … the final days to implement Version 5010 are here!

Beginning January 1, 2012, all providers who use electronic transactions on a daily basis for claims, eligibility determinations, remittances, or referral authorizations will have to be compliant with the new version to receive payments or communication for patient claims.

more From the College


Ethics Forum: The Ethics of Accepting Gifts

The holiday season is here and I certainly enjoy receiving gifts as much as anyone. We have been either educated about declining—or forbidden to receive—gifts from pharmaceutical companies, but these are not the only source of gifts. A few years ago, I discovered a private physical therapist was located only a few blocks from my office.

Ethics Forum: Letters from our Readers

The ethics of ultrasound

We received several letters in response to the September 2011 “Ethics Forum,” which asked about the proper way to adopt ultrasound in your practice. We thank our respondents for their thoughtful and provocative comments. As many of you are aware, the ACR is currently drafting guidance for the use of musculoskeletal ultrasound. Perhaps we will rethink this topic once these are available.

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A Productive Year Ahead

Rheumatologists face challenges and unique opportunities in the coming year

Thank you for the tremendous honor of serving as ACR president. Given that this is my first column, I’d like to briefly introduce myself, outline a few of the challenges that we will face in 2012, and ask for your help in advancing rheumatology this next year. Only with the help and combined wisdom of our volunteers, members, and staff will we continue to thrive.

A Walk in the Windy City

A final column full of many thanks and a few parting thoughts

Preparing to write my final “Rheumination,” I have had the same sense of anxiety, tension, and even dread that TV screenwriters must have felt as they composed the last episode of Cheers, Seinfeld, or Friends. The temptation is great to be memorable but nevertheless stay true to the character of the show. The Rheumatologist (TR) is a limited circulation publication, not a TV franchise, however, and we do not expect a boost in ratings as readers flock to the newsstand to snatch a copy to learn...


Honoring two amazing rheumatologists and the amazing patients they serve

God wept. They trudged and limped into the clinic. Those that could, stood in line; others waited seated, filling the waiting area and corridors. Approximately 250 patients are seen at the rheumatology clinic at LAC (Los Angeles County Medical Center) + USC (University of Southern California) each week. Our nurses see another 150 patients weekly, and we average another 10 to 15 inpatient consultations each week.

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The Clinician's Role in Rehabilitation Therapy

Learn when and how to refer a patient to a physical or occupational therapist or other specialist

Clinicians need to know when and how to provide rehabilitation services for their patients, either within the clinic or office setting or by referral to physical or occupational therapists. Understanding rehabilitation principles and the basic exercises for common rheumatic and orthopedic conditions can help improve patient management.

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