As a physician, I am an advocate. I am an advocate for my patients individually and collectively, and I am an advocate for my field: pediatric rheumatology. My own experiences as a patient drive me to integrate my patients’ perspectives into my medical decision making, and although my academic training has prepared me to best…
Why & How Our Biologic Drug Discussion with Patients Should Evolve
As we turn the corner on the second decade of biologic use for rheumatic disorders, a reappraisal of approach in our communication with patients is due. In practice, the impact these agents have on patients’ lives justifies the friction rheumatologists face when connecting patients to them. You can understand why older rheumatologists who apprenticed on…
Moments That the Words Don’t Reach
There are moments that the words don’t reach There is suffering too terrible to name You hold your child as tight as you can And push away the unimaginable —Lin Manuel Miranda A friend of mine was killed a few days ago. By the time you read this column, the scars will have already started…
2019 RheumPAC Resolutions
This year’s RheumPAC members are excited to build on their 2018 accomplishments. In 2018, we raised $144,000 from 323 individual investors. Thank you to everyone who invested and to those who supported advocacy for ACR/ARP, its members and our patients. We also introduced a new way for non-individuals (e.g., rheumatology practices, state and local rheumatology…
Predicting the Unpredictable – Taming the Impulse to Treat
One of my fellows could take better care of his patients if it weren’t for the attendings getting in his way. Or so he tells me. I can hear the howls of protest already. This statement isn’t fair—it is too broad, it doesn’t fairly depict the nuances of the situation or his point of view. First,…
Why I Chose to Be Part of RheumPAC
As physicians, we play an important role in the well-being of patients and serve as advocates to ensure our patient receives adequate healthcare services. Unfortunately, many of the policy decisions that govern our medical practices are made by bureaucrats with inadequate input from physicians. Certain constraints placed on the way we should practice medicine have…
Do Not Get Us Started on Acthar
As rheumatologists, we have a love-hate relationship with the corticosteroid prednisone, a feeling many of our patients share. It’s our most effective medication to quickly shut down an overactive immune system. When we have a patient with life- or organ-threatening autoimmune disease—severe lupus affecting the kidneys or vasculitis causing hemorrhage in the lungs, for example—large…
Physician-Editor Discusses Lessons Learned after 1 Year on the Job
2018 is coming to a close, and somehow, I have managed to make it through a year as the physician editor of The Rheumatologist without being sued or fired, so I thought this would be a good time to pause and reflect on lessons learned—and to give thanks. My first lesson: this is a lot of…
The Non-Linear Path of Discovery, & Publicly Funded Research
Black powder was initially developed in 9th century China, by Taoists searching for the philosopher’s stone, which fans of Harry Potter will remember is the talisman that grants eternal life. The Chinese name for black powder literally translates as fire medicine. The chemical composition of black powder was first recorded in China during the 11th…
Administrators & Payers Have Hijacked Our Medical Records
I attended medical school in the 1960s, when Dr. Lawrence Weed reinvented the medical record to organize and leverage the physician’s patient evaluation for clarity and quality of care—what he dubbed “the problem-oriented medical record.”1,2 My internal medicine house officer training at Massachusetts General placed a high value on efficient, effective medical records and communication…
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