Mentoring, Educating, Discussing
Dr. Bernhard describes a challenging case he consulted on in 2018, when he was speaking with a primary care physician at a Florida clinic that provided free healthcare services.
“The differential diagnoses [included] several possibilities, and access to a rheumatologist was virtually [impossible],” he says. Dr. Bernhard says he created a simple treatment plan based on what appeared to be the most likely diagnosis. “The unfortunate part about this was there wasn’t adequate feedback or follow-up by the physicians with me, perhaps because of their hectic schedules.”
MAVEN hopes to improve such follow-up with e-consults and better education of participating clinic physicians about rheumatology conditions and treatment options.
Recently, Dr. Bernhard developed content for potential case discussions that could serve as the foundation for an upcoming seminar. He’ll present physicians and physician assistants with a case he dealt with years ago to kickstart discussions. The idea is to address how to discriminate between inflammatory back pain and mechanical back pain, weed out fibromyalgia patients from those with inflammatory connective tissue diseases, interpret data from lab results, and ultimately determine the diagnosis and treatment options for the patient.
Meanwhile, he says MAVEN is involved in mentoring physicians and PAs and will explore ways for clinics to access free, sophisticated lab services conducted in their community.
“Physicians at these clinics are overwhelmed by the volume of patients they see,” says Dr. Bernhard. “If they’ve got administrative problems at the clinic, I can’t help them beyond listening to them. This is the most frustrating part of mentoring.”
Dr. Bernhard also volunteers for the ACR’s VERA (Volunteers to Expand Rheumatology Access) initiative, which is a clearinghouse for ACR members who want to engage in volunteer work. MAVEN is simply one volunteer opportunity available to ACR members.
He says both programs give him a much better understanding of the needs of PAs and primary care physicians who are out in the field and help identify areas needing improvement.
“MAVEN is currently gathering data from the clinics, which will give us a clue as to whether or not we’ve made any inroads or are benefitting these clinics and their patients,” says Dr. Bernhard.
“Volunteering keeps me engaged in what I really love to do, which is to improve clinical care by consultation and education, and it also makes me a more effective preceptor for our rheumatology fellows at UCSF,” he says.
Carol Patton, a freelance writer based in Las Vegas, Nev., writes the Rheum after 5 column for The Rheumatologist.
Editor’s note: Listen to Dr. Bernhard talk more about the MAVEN Project and why he chooses to be a volunteer.
