The Rheumatologist
COVID-19 News
  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed
  • Home
  • Conditions
    • Rheumatoid Arthritis
    • SLE (Lupus)
    • Crystal Arthritis
      • Gout Resource Center
    • Spondyloarthritis
    • Osteoarthritis
    • Soft Tissue Pain
    • Scleroderma
    • Vasculitis
    • Systemic Inflammatory Syndromes
    • Guidelines
  • Resource Centers
    • Ankylosing Spondylitis Resource Center
    • Gout Resource Center
    • Psoriatic Arthritis Resource Center
    • Rheumatoid Arthritis Resource Center
    • Systemic Lupus Erythematosus Resource Center
  • Drug Updates
    • Biologics & Biosimilars
    • DMARDs & Immunosuppressives
    • Topical Drugs
    • Analgesics
    • Safety
    • Pharma Co. News
  • Professional Topics
    • Ethics
    • Legal
    • Legislation & Advocacy
    • Career Development
      • Certification
      • Education & Training
    • Awards
    • Profiles
    • President’s Perspective
    • Rheuminations
    • Workforce
  • Practice Management
    • Billing/Coding
    • Quality Assurance/Improvement
    • Workforce
    • Facility
    • Patient Perspective
    • Electronic Health Records
    • Apps
    • Information Technology
    • From the College
    • Multimedia
      • Audio
      • Video
  • Resources
    • Issue Archives
    • ACR Convergence
      • Systemic Lupus Erythematosus Resource Center
      • Rheumatoid Arthritis Resource Center
      • Gout Resource Center
      • Abstracts
      • Meeting Reports
      • ACR Convergence Home
    • American College of Rheumatology
    • ACR ExamRheum
    • Research Reviews
    • ACR Journals
      • Arthritis & Rheumatology
      • Arthritis Care & Research
      • ACR Open Rheumatology
    • Rheumatology Image Library
    • Treatment Guidelines
    • Rheumatology Research Foundation
    • Events
  • About Us
    • Mission/Vision
    • Meet the Authors
    • Meet the Editors
    • Contribute to The Rheumatologist
    • Subscription
    • Contact
  • Advertise
  • Search
You are here: Home / Articles / What Our Colleagues Should Know: Integrated Care for the Lungs

What Our Colleagues Should Know: Integrated Care for the Lungs

February 17, 2017 • By Richard Quinn

  • Tweet
  • Email
Print-Friendly Version / Save PDF

Connective tissue disease-associated interstitial lung disease (CTD-ILD) doesn’t recognize the difference between pulmonologists and rheumatologists, says Aryeh Fischer, MD, associate professor of medicine, Division of Rheumatology, Division of Pulmonary Sciences and Critical Care Medicine, at University of Colorado School of Medicine in Denver. Thus, “we need to be less rigid in our subspecialization (i.e., have fewer academic and clinical ‘silos’).

You Might Also Like
  • Listen to the Lungs: An Interview with Dr. Aryeh Fischer on ILD
  • Summit on Connective Tissue Disease-Associated ILD Fosters Interdisciplinary Dialogue
  • ACR/ARHP 2016 Research Conferences Foster Exchanges with Colleagues Before Annual Meeting Start
Also By This Author
  • Space Traveling Mice Provide Insight into Osteoporosis

“These multisystem diseases mandate a multisystem approach,” he adds. “And unfortunately, our training system after general internal medicine often breeds more of a compartmentalized approach.”

ad goes here:advert-1
ADVERTISEMENT
SCROLL TO CONTINUE

Pulmonologists and rheumatologists can work together on many clinical and practice management decisions relating to connective tissue disease to improve patient care, Dr. Fischer says. For example, both specialists need to proactively focus on the status of patients’ lungs, because “waiting for symptoms is too late.” What Dr. Fischer means is that patients with rheumatic disease lead sedentary lifestyles. That lack of activity means that if pulmonologists wait until symptoms of lung issues develop, it might be too late to solve those issues. Instead, more proactive attention paid to the lungs could help prevent those problems from ever developing, Dr. Fischer believes.

Dr. Fischer says pulmonologists dealing with rheumatologic patients should attempt to view the patient’s signs and symptoms from the rheumatologist’s point of view. And vice versa.

ad goes here:advert-2
ADVERTISEMENT
SCROLL TO CONTINUE

“We need to better understand our respective perspectives and how we approach our shared diseases,” he adds. “I think CTD-ILD is a paradigm for such collaboration. I have been fortunate to work mostly within a ‘lung’ environment. This has helped me better appreciate where the pulmonologist is coming from.

“It has helped me understand the scenario when a pulmonary provider may suggest there is an autoimmune component to a patient’s lung disease—even in the absence of more characteristic extrathoracic manifestations of CTD. So when my pulmonary colleague tells me, ‘I think the ILD may be autoimmune,’ I feel I have a better appreciation for that perspective by appreciating their approach.”

Sometimes that collaboration is forced by circumstances, because a rheumatologist may not have the time to be involved in one part of a patient’s case.

ad goes here:advert-3
ADVERTISEMENT
SCROLL TO CONTINUE

“If we are not going to assess for lung involvement ourselves—a realistic limitation given the numerous other aspects needing to be addressed, short visits, etc.—then we should consider having our patients see [a pulmonologist] for ‘screening’ assessments for multi-compartment lung disease,” Dr. Fischer adds. “If rheumatologists are not able to assess for lung involvement, then pulmonary referral is indicated for these assessments in any of our higher-risk patients, essentially any of our patients with connective tissue disease. Waiting for symptoms is too late. All CTD patients are at risk for lung disease—some more than others—and if we aren’t going to be able to assess for occult lung disease, then we need dedicated pulmonary consultation to do it for us.”

Pages: 1 2 | Single Page

Filed Under: Career Development, Education & Training, Professional Topics Tagged With: Interstitial Lung Disease, lungs, pulmonologists, rheumatologists, Scleroderma

You Might Also Like:
  • Listen to the Lungs: An Interview with Dr. Aryeh Fischer on ILD
  • Summit on Connective Tissue Disease-Associated ILD Fosters Interdisciplinary Dialogue
  • ACR/ARHP 2016 Research Conferences Foster Exchanges with Colleagues Before Annual Meeting Start
  • Can Integrated Care Lead to Better Outcomes?

Meeting Abstracts

Browse and search abstracts from the ACR Convergence and ACR/ARP Annual Meetings going back to 2012.

Visit the Abstracts site »

Rheumatology Research Foundation

The Foundation is the largest private funding source for rheumatology research and training in the U.S.

Learn more »

American College of Rheumatology

Visit the official website for the American College of Rheumatology.

Visit the ACR »

The Rheumatologist newsmagazine reports on issues and trends in the management and treatment of rheumatic diseases. The Rheumatologist reaches 11,500 rheumatologists, internists, orthopedic surgeons, nurse practitioners, physician assistants, nurses, and other healthcare professionals who practice, research, or teach in the field of rheumatology.

About Us / Contact Us / Advertise / Privacy Policy / Terms of Use

  • Connect with us:
  • Facebook
  • Twitter
  • LinkedIn
  • YouTube
  • Feed

Copyright © 2006–2021 American College of Rheumatology. All rights reserved.

ISSN 1931-3268 (print)
ISSN 1931-3209 (online)

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.