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CMS Cancels Medicare Part B Demonstration Project

From the College  |  December 16, 2016

When the controversial Medicare Part B Drug Payment Model final rule was not released by the Centers for Medicare & Medicaid Services (CMS) as expected before Nov. 21, it signaled an increasing likelihood of defeat for the proposed rule—a signal proved true on Dec. 15. A spokesperson for the CMS said, “After considering comments, CMS…

When Chronic Pain Is Personal

Karen Appold  |  December 16, 2016

Opening up to patients about a medical condition is a personal choice for physicians. But for Richard Brasington, MD, who has chronic back pain and arthritis, it helps him communicate with and connect to some of his patients. In an interview, he provides insights into his experiences managing pain on the job…

The Future of Pediatric Rheumatology Grounded in Evolution of Childhood Arthritis and Rheumatology Research Alliance

Yukiko Kimura, MD, & Laura E. Schanberg, MD  |  December 15, 2016

Pediatric rheumatology was formally recognized as a specialty in 1991 by the American Board of Pediatrics. Prior to this time, children with rheumatic diseases were treated by a hodgepodge of providers. In addition to providers who had training as pediatric rheumatologists, general pediatricians, adult rheumatologists, allergist-immunologists, orthopedists, pediatric infectious disease specialists and others treated children…

Rheumatology Case Report: Systemic Capillary Leak Syndrome and Rheumatoid Arthritis

Alexis Smith, MD, & Angus Worthing, MD, FACP, FACR  |  December 15, 2016

Systemic capillary leak syndrome (SCLS) is a very rare disorder, characterized by recurrent episodes of severe hypotension, hypoalbuminemia and hemoconcentration.1 Attacks of SCLS occur in three phases: 1) prodrome; 2) hypovolemia with weight gain; and 3) hypervolemia with fluid overload and polyuria often complicated by pulmonary edema. Often, compartment syndrome can lead to rhabdomyolysis as…

How Hospital Design Can Promote Better Patient Outcomes

Simon M. Helfgott, MD  |  December 15, 2016

A storm has been brewing down the street from my office. It is a David & Goliath dispute, pitting young children and their families against a renowned pediatric institution, Boston Children’s Hospital. It concerns the fate of a half-acre swath of green space, the Prouty Garden, replete with meandering paths, fountains and a towering redwood…

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Assessing Autoimmune Disease Symptoms in Silicone Breast Implant Recipients

Charles Radis, DO  |  December 15, 2016

My nurse, Joanne, took me aside before I began my next consult. “Room No. 5, breast implant patient. Her lawyer organized the records.” She handed me a hefty three-ring notebook organized by color-coded tabs. “Her attorney called just now,” Joanne raised an eyebrow, “and told me to tell you that, to save time, he highlighted…

Infection Greater Worry Than Flare: Collaborative Guideline Offers Guidance to Prevent Joint Replacement Complications & Failure

Susan Bernstein  |  December 14, 2016

WASHINGTON, D.C.—Total joint arthroplasty is one of the most common surgical procedures performed on adults with end-stage arthritis. One recent estimate showed that 2.5 million individuals in the U.S. are living with a total hip replacement and 4.7 million are living with knee replacements. For their patients with inflammatory arthritis, rheumatologists and orthopedic surgeons must…

A New Approach to Fracture Prevention

Susan Bernstein  |  December 14, 2016

Glucocorticoids are widely prescribed by rheumatologists, and the effects of daily and cumulative doses of these drugs on bone mineral density (BMD) are important elements of a draft clinical guideline document presented on Nov. 13 at the 2016 ACR/ARHP Annual Meeting in Washington, D.C. Leaders of the ACR guideline project discussed their recommendations at the…

MACRA: More Points, Smarter Future

Susan Bernstein  |  December 14, 2016

As the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is implemented in January with new models for quality-based reimbursement payments, rheumatologists must seize control of how they will be paid now—and in the future. This message was stressed by speakers during Holy MACRA! How to Survive and Thrive in the Era of MACRA,…

Advocating Where It Counts: A Conversation with Incoming Government Affairs Committee Chair Angus Worthing, MD, FACR, FACP

Carina Stanton  |  December 14, 2016

As he prepares to take on his newest volunteer role with the ACR, leading the Government Affairs Committee (GAC), Angus Worthing, MD, FACR, FACP, is looking forward to making the most of the opportunities that a unified government can offer the ACR in advocating for rheumatology care. “Advocacy is an investment in our profession—regardless of…

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