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Chart a New Course: A Rheumatologist Talks about Practicing in an Orthopedic Environment

Karen Appold  |  December 30, 2016

Dr. Francis also faced administrative challenges, such as with MACRA reporting. “MACRA reporting has been significantly delayed because our electronic health record (EHR) system is not yet compatible with the current reporting needs,” she says. “As the practice is evolving to recognize the expanding future needs for reporting to various clinical registries, we are at the threshold of acquiring a new EHR system that will make the process much more efficient.”

Combining Silos Makes Sense
Alfonso E. Bello, MD, MHS, FACP, FACR, DABPM, a clinical associate professor of medicine at the University of Illinois College of Medicine at Chicago and director of rheumatology research at Illinois Bone & Joint Institute LLC, has found that having rheumatologists and orthopedists in the same practice works well, because patients with musculoskeletal disorders often see an orthopedic surgeon first, even though they may not need a surgical procedure.

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“Many times, patients are seen by orthopedic surgeons as their first musculoskeletal specialist when, in fact, they may be better served by a rheumatologist,” he says. “My orthopedic partners are well equipped to identify patients with rheumatologic disorders and facilitate transfer of care to me—thereby accelerating proper care.”

This arrangement also makes sense because rheumatologists often use or prescribe the same ancillary aspects as orthopedists, such as magnetic resonance imaging and physical therapy. What’s more, Dr. Bello finds it beneficial to communicate directly with the surgeons who he refers patients to, and vice versa.

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Dr. Bello, who used to work at a multi-specialty practice, notes that in some instances patients need to see both a rheumatologist and an orthopedist. “[Because we’re] both under the same roof, we can provide convenient and well-rounded comprehensive care. I think the wave of the future will be to combine these two silos.”


Karen Appold is a medical writer in Pennsylvania.

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Filed under:Career DevelopmentProfessional Topics Tagged with:Career developmentClinical Practicehealth professionalorthopedicpatient careProfessional Topicsrheumatologist

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