From: The Rheumatologist, January 2012
Successes, challenges, and controversies of diagnostic methods for APS
Since the mid-1980s, antiphospholipid (aPL) antibodies and their associated clinical manifestations have attracted great interest among clinicians and investigators. Indeed, the attention directed to aPL often exceeds that for other autoantibodies within the field of autoimmunity. Even in systemic lupus erythematosus (SLE), which is characterized by a multitude of specificities, the interest in this serological system remains high. The lupus anticoagulant (LAC) was first recognized more than 60 years ago,...
The Rheumatologist welcomes new editorial team
The 2012 New Year brings a changing of the guard at The Rheumatologist (TR) as we welcome a new editorial team: Physician Editor Simon Helfgott, MD, and Associate Editors Richard Brasington, MD, and Maura Iversen, PT, MPH. All three rheumatology specialists bring a rich background of clinical, academic, and leadership expertise to TR.
Rheumatologists recognized for their work in the field
Distinguished Basic Investigator Award - Steven Abramson, MD; Distinguished Basic Investigator Award - Gregory Dennis, MD; ACR Excellence in Mentoring Award - Betty Diamond, MD; ACR Distinguished Clinical Investigator Award - Edward Giannini, MSc, DrPH; Henry Kunkel Young Investigator Award - Karen H. Costenbader, MD, MPH; Henry Kunkel Young Investigator Award - Theresa Lu, MD, PhD; ACR Paulding Phelps Award - Gary Bryant, MD, FACP, FACR; ACR Distinguished Clinician Scholar Award - Stephen Paget, MD; ACR...
From the College
Nearly 10 million Americans suffer from carpal tunnel syndrome, a condition that disables a key nerve in the wrist resulting in numbness, tingling, weakness, and loss of function in the hands and wrist. These symptoms are similar to those of rheumatoid arthritis and other rheumatic conditions, and it is important that patients know the difference.
Carpal tunnel syndrome is possibly the most common nerve disorder experienced today. The carpal tunnel is located at the wrist on the palm side of the hand just beneath the skin surface (palmar surface). Eight small wrist bones form three sides of the tunnel, giving rise to the name carpal tunnel. The remaining side of the tunnel, the palmar surface, is composed of soft tissues, consisting mainly of a ligament called the transverse carpal ligament. This ligament stretches over the top of the tunnel.
Not verifying insurance benefits prior to rendering service can result in nonpayment, which affects your bottom line. Because this is a costly mistake that can be avoided, make it routine to verify eligibility prior to every patient visit.
What’s in Store for Rheumatology in 2012?
After a tumultuous December, Congress will convene again in Washington, D.C., this month. Many health policy issues affecting the rheumatology community were left on the table at the end of the first session of the 112th Congress. The ACR will work diligently with key lawmakers and our supporters in Congress to address pressing issues affecting rheumatologists, including the following.
Are you looking for a better rheumatology-focused, on-the-job training program for a nurse practitioner, physician assistant, or other clinician? Do you and your colleagues want to continue building competence in the care of people with rheumatic disease? If so, the Advanced Rheumatology Course may be just what you need.
January's Coding Challenge
January's Coding Answer
The ACR is pleased to continue its welcome of the newest members of the ACR board of directors and ARHP executive committee. These new members were confirmed last November during the ACR/ARHP Annual Scientific Meeting in Chicago. In the December 2011 “From the College,” we introduced you to several new members (“Welcome New ACR and ARHP Leaders,"). In this issue, you will meet the rest of the new members joining the leadership ranks and learn what they want to gain from their...
Karen Kolba, MD and Robert A. Colbert, MD, PhD
Laurie Hughell, PA- C, MPH and Susan Richmond, MS, PA-C
The ARHP is the premier professional organization for rheumatology health professionals primarily because of the talent and energy of its volunteers and staff. The ARHP needs both new and experienced volunteers to continue its mission, meet new challenges, and grow as an organization. Each and every ARHP member brings unique talents, abilities, and expertise to our organization, and we need your participation. Volunteer opportunities are available to all ARHP members, including international and associate...
Building relationships with your referring physician pool and their staff should increase the number of quality referrals you receive. Rheumatologists and health professionals should personally introduce themselves to referring doctors in the community. Networking and increasing involvement within the community also builds your reputation and markets your services. Existing patients play a significant role because word of mouth is a powerful tool for referrals to your practice.
A 33-year-old woman presents with somewhat pruritic, nodular lesions worsening over the past three months in the site of a newly placed tattoo. The nodules are restricted to certain portions of the tattoo only.
Information on new approvals and medication safety
According to the Food and Drug Administration (FDA), 35 drugs were approved in the past 12 months, as of this writing, surpassing the number approved in 2009 by two.1 The recently passed agents include important medical advances in the fields of hepatitis C, where two new agents were approved, and systemic lupus erythematosus (SLE), where belimumab was the first new lupus agent to be approved in 50 years. Innovative processes were used to approve these new medications while not compromising drug safety....
While advertising is a great way to promote your practice, be sure to avoid legal pitfalls
A rheumatologist I know recently decided to launch a marketing campaign in an attempt to increase his patient base and enhance the reputation of his practice in the community. As part of these marketing activities, he hired an advertising agency to develop a campaign that would appear in local media outlets. While he excitedly mentioned this new venture to me as a side note in conversation, I was immediately concerned. Advertising executives are experts in creative marketing, not the law. I urged the...
Rituals, symbols, ceremony, and tradition
Let me tell you about a series of seemingly unrelated events and how they do, in fact, connect with each other—and with something in the current literature.
Expanded opportunities to advance rheumatology will be offered by ACR’s ongoing registry efforts
Regardless of all the uncertainty in the current healthcare environment, one thing is clear: demonstrating quality patient care by adhering to guidelines and best practices and using data to monitor and improve gaps in patient care and outcomes will continue to increase in significance. Quality improvement initiatives have received bipartisan support and have been pervasive in both Republican and Democratic administrations. Irrespective of whether the Supreme Court determines parts of the Affordable Care...
Or, why I chose to become a rheumatologist
Why did you want to become a rheumatologist? For me, the decision wasn’t hard. As a medical resident, reading electrocardiograms at 2 am—or at 2 pm for that matter—didn’t appeal to me. Endocrinology seemed to lack any complexity; a simple look at lab tests either meant the patient was or was not hypothyroid. I lacked the passion for inserting endoscopes into any orifice. I had whittled my choices to a few remaining possibilities, and then I experienced a defining medical moment. I...
Finding the glamour in a humble field
Although when I was a medical student, rheumatology was always associated with an air of mystery and complexity to me—factors that might have aroused a younger me had they been associated with a member of the opposite sex—the specialty didn’t catch my eye at all as an undergraduate. To a medical student cruising for medical action in the 1980s, rheumatology wouldn’t have gotten as far as a first date.
Theory of condition-specific ‘brain signature’ sparks controversy
Chronic pain in osteoarthritis changes the brain and imparts a unique “signature” of morphologic or functional characteristics in the brain that may have future clinical implications, according to research presented at the 2011 ACR/ARHP Annual Scientific Meeting held in Chicago in November.
Learn motivational interviewing and cognitive behavioral tools that can guide patients to improve their health
When counseling a patient who has arthritis about health behavioral change, rheumatology health professionals should resist the urge to give advice. Instead, allow the patient to do most of the talking.
Researchers say it may even correlate with back, hip, and knee pain
Foot pain, which affects an estimated 24% of the adult population, is even more prevalent in patients with arthritis. Although treatment of foot problems remains challenging, research is improving our understanding of the mechanisms, evaluation, and management of foot pain.
New targets in rheumatoid arthritis: SYK, JAK, BTK
Researchers are uncovering new drugs with new mechanisms of action that span the distance between the basic science of immunology and the clinic. It is important that clinicians understand the underlying background and targets of these new drugs in order to apply these advances in treating rheumatoid arthritis (RA). RA researchers are approaching the onset of a new era of therapeutic agents that combine the ease of oral administration with therapeutic efficacy that may be as effective as antibody-based...
Innovations in health information technology can have significant impact
The implementation of a bundle of quality measures for rheumatoid arthritis (RA) helped identify gaps in care delivery, and another quality improvement study resulted in increased safety of intravenous infusions at a pediatric rheumatology practice. These abstracts were among six presented at a session titled, “Quality Measures and Innovations in Practice Management and Care Delivery I,” here at the 2011 ACR/ARHP Annual Scientific Meeting in Chicago in November.