Brett Smith, DO, Rheumatologist, East Tennessee Medical Group, Alcoa, Tenn.
Background: Dr. Smith doesn’t get his Distinguished Fellows Award. It’s not that he didn’t receive it, mind you. He just doesn’t understand why he did.
“It’s still very surprising to me simply because I don’t really consider myself to be on a platform to receive that privilege,” he says. “From a professional standpoint, it’s very humbling.”
Dr. Smith earned his medical degree at the University of Medicine and Dentistry of New Jersey and did his residency at the University of Kentucky. He completed his rheumatology training at Wake Forest University Baptist Medical Center in Winston-Salem, N.C.
At Wake Forest, he studied the effect of metformin on self-reported pain scores in patients with Type 2 diabetes. He also worked on a quality improvement project focused on identification of cognitive dysfunction in elderly patients with rheumatoid arthritis (RA). The study aimed to identify a cost-effective intervention.
Q: What lured you to rheumatology?
A: My mother has psoriatic arthritis. I’ve seen her ups and her downs through having an inflammatory condition, so that was what originally piqued my interest. And then I worked around some really good people when I was an internal medicine resident … and they were just really, really good mentors. If you see somebody with hypertension, you can control their blood pressure and improve their long-term outcomes. But they may not necessarily notice a difference, per se. In rheumatic disease, people usually feel so poorly and you can turn them around in a short period of time. Very satisfying for the patient and for you.
Q: How much has the progression of treatment options pleased you?
A: It’s kind of unbelievable actually … when you start with gold and D-penicillamine and a couple of these older drugs, then all of the sudden you’ve got 25 options for rheumatoid and you’ve got 15 options for psoriatic arthritis. It’s just amazing the explosion of the understanding of immunology and treatment options.
Q: Do you see that kind of progress continuing?
A: We’re just scratching the surface of immunology and what these drugs mean for people and the different pathways. Europe’s a little bit ahead of us in the biosimilars and we’re trying to get them here. There’s a lot of pathways still to be discovered because research is ongoing … there’s definitely a lot of room for expansion and understanding of disease mechanisms.
