Enter second opinion consulting.
I found a company that connects me to patients in need of a second opinion—or sometimes, simply a doctor who listens to them and answers their questions. Some patients are undiagnosed while others have a diagnosis but want a second, expert opinion. Some patients just want to understand more about their conditions and medications. This work allows me to be the doctor I want to be: A doctor who has the time, space and energy to take care of patients the way she was trained.
Also, I knew I wanted to improve access to care.
During my time in academics, I had become an accidental rheumatology advocate, caring for a primarily uninsured and non-English speaking population. The waitlist to see me was over a year long. However, not all those referrals needed to be seen in person. Also, the patients who did need an in-person visit could have started treatment with disease-modifying anti-rheumatic drugs (DMARDs) prior to their appointments with great benefit—if only their primary care providers (PCPs) had had a little guidance from a rheumatologist.
Enter e-consults.
I found companies that connect me to PCPs in rural and/or underserved areas who are concerned about possible rheumatic disease in their patients. Via simple HIPAA-protected electronic platforms, PCPs can submit a consult question, clinical notes and labs for their patient. Within 24 hours, I review the information and send them advice. In three to five minutes, I get to change a patient’s life and make a PCP’s life much easier.
Clinical Education, But Different
Little in life gives me as much of a rush as teaching a room full of people about rheumatology—especially if you give me a microphone. I have found a handful of opportunities to lecture since leaving academics. I once taught doctors in Mongolia about rheumatology labs, and my talk was subtitled in the Mongolian Cyrillic alphabet. This moment was a peak for me as an educator.
These days, my primary outlet for teaching is right here, writing for The Rheumatologist and its audience. Believe it or not, I actually get paid to interview experts and write articles that translate the latest and greatest in clinical research for practicing rheumatologists. It’s the coolest.
Consulting, But Different
Rheumatologists are uncommon, and our knowledge is valuable. No one communicated this idea better to me than my business-savvy little brother, Jon, who helped me set up a LinkedIn profile for self-promotion.
