Three clinical experts on gout offer their insights into common management errors, clinical pearls, new safety data from the FDA and the role of biologic therapies in the management of gout.
The Look Back: ACR President Dr. Paula Marchetta Recaps 2019
We all have a short list of famous individuals whose writings inspire us and guide us. At the start of my presidential year, I turned to my own short list for some words of wisdom from Peter Drucker, whom many consider to be the founder of modern management theory. Underpinning Drucker’s teachings is a strong…
The 2019 ARP Awards of Distinction & ACR Masters
ATLANTA—At the 2019 ACR/ARP Annual Meeting in November, the ACR and the ARP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. This month, The Rheumatologist speaks with the winners of the ARP Merit Awards about their individual contributions to advancing rheumatology. You’ll also find a…
One-Quarter of Every U.S. Healthcare Dollar Wasted
(Reuters Health)—About a quarter of the dollars spent on healthcare in the U.S. may be wasted, a new analysis suggests. Six types of waste in healthcare could be costing as much as $935 billion annually, according to the study published in JAMA.1,2 The biggest source of waste is “administrative complexity,” says the study’s lead author…
Professional Coaching Improves Physician Wellbeing
Many physicians struggle with work–life balance, and burnout is a growing professional concern. New research suggests professional coaching may effectively reduce emotional exhaustion in physicians and improve their quality of life…
Case Report: A Patient with Gout Develops Granulomatous Hepatitis
Case Presentation A 45-year-old man with crystal-proven gout, poorly controlled diabetes and chronic kidney disease was lost to follow-up for six years and presented back to the VA clinic in the midst of a gout flare. He stated he had continued taking 100 mg of allopurinol daily, but his serum urate level was 13.8 mg/dL….
Case Report: Tumor Treatment Unleashes Autoimmunity
Immune checkpoint inhibitors (ICIs) targeting the cytotoxic T-lymphocyte-associated protein 4 (CTLA-4) or programmed cell death protein 1 (PD-1) axes have revolutionized therapy and improved survival in advanced cancers. However, these immune system modulators also lead to immune-related adverse events (IRAEs).1,2 In clinical trials, IRAEs mainly involved the gastrointestinal tract, skin, endocrine glands, liver and lung,…
Survey Sheds Light on Physician Retirement
According to a survey commissioned by CompHealth, doctors work longer than the average American, intending to retire at age 68.1 Eventually, most physicians do decide to pull the plug on their careers. Questions about when to retire and what happens next are important to answer. “The primary question to ask yourself is, ‘Do I still…
Case Report: Rheumatoid Arthritis-Associated Restrictive Pericarditis
Rheumatoid arthritis (RA) is a systemic autoimmune disease that affects approximately 1% of the adult population, and involvement of extra-articular tissue occurs in approximately 40% of patients over their lifetimes.1 RA-associated pericardial disease is an uncommon complication, and surgery is the only definitive therapy—according to current literature. In this report, we present the case of…
Ultrasound Aids Diagnosis of Man with Knee Pain & Swelling
A 56-year-old automobile mechanic was referred to our rheumatology service by his orthopedist to evaluate left posterior knee pain and swelling that had been present for three months. The patient had undergone bilateral total knee arthroplasties (TKAs) for sports-related osteoarthritis three years before. In addition to the knee pain, the patient described several years of…
ACR Survey Seeks to Better Define Conflicts of Interest
Recognizing that situations involving ties with the pharmaceutical industry and conflicts of interest are often not black and white, the ACR’s Committee on Ethics and Conflict of Interest has collected feedback on four ethically challenging scenarios to gauge how rheumatology providers think about them. The survey generated responses that were often mixed, showing that when…
Dr. Jonathan Paramo: Rheumatologist & Parrot Enthusiast
Excluding the years he spent in medical school, Jonathan Paramo, MD, has always kept birds as pets. As an animal lover, he believes he shares a special chemistry with birds, specifically any species of parrots. When he’s around them, he says he experiences “a special feeling.” “There are cat lovers and dog lovers, but you…
Abx464 Enters Phase 2 Clinical Trials for RA in Europe
In Europe, researchers are evaluating the safety, tolerability and efficacy of ABX464 in rheumatoid arthritis patients…
FDA Approves Ixekizumab for Treating Active Ankylosing Spondylitis
Data from two phase 3 studies were used to support the FDA’s approval of ixekizumab for adults with ankylosing spondylitis…
Nintedanib Slows Lung Deterioration in General Fibrosing Interstitial Lung Disease
NEW YORK (Reuters Health)—Nintedanib dramatically slows lung deterioration in patients with progressive fibrosing interstitial lung diseases, according to a new randomized study.1 Nintedanib has already been shown to be effective against idiopathic pulmonary fibrosis (IPF). The new trial, funded by the manufacturer, Boehringer Ingelheim, and presented t the European Respiratory Society International Congress 2019 in…
Leading Boldly: Transforming Rheumatology Campaign Makes Progress
In 2018, the Rheumatology Research Foundation embarked on its third and most ambitious fundraising campaign, Leading Boldly: Transforming Rheumatology, with a goal of raising $75 million over five years. The campaign supports Foundation programs to recruit the best and brightest into the field, train rheumatology professionals at all career stages and support investigators conducting research…
The ARP Aids Rheumatology Workforce Expansion Via Online Education
The Advanced Rheumatology Course (ARC) carries the distinction of being the first online educational product of the ACR/ARP. In the early 2000s, members of the College thoughtfully considered action needed to efficiently prepare health professionals looking to enter the rheumatology workforce. A decision was made to create online educational products with the specific target audience…
Rheumatology Patients & Providers Push for Step Therapy, Workforce Changes
Rheumatology professional and patients visited with 117 legislators and their staffs during the 2019 Advocates for Arthritis event to champion better rheumatology patient care and access.
How to Navigate & Manage Insurance Overpayments
Insurance overpayments can occur in a practice for a variety of reasons. An insurer may simply make a mistake by paying a provider more than the contracted amount for a service or pay for a service that is not covered under the patient’s insurance plan. Whatever the reason, overpayments can and will create headaches for…
Coding Corner Questions: Navigating Medicare’s Online Resources
A practice receives an overpayment request from the Centers for Medicare & Medicaid Services (CMS) for not meeting medical necessity related to a biologic infusion. In which instructional guideline can the coding and billing staff find the necessary information on the CMS website to handle this request? Internet-only manuals National Correct Coding Initiative Medically Unlikely…
Coding Corner Answers: Navigating Medicare’s Online Resources
Take the challenge. 1. A—Internet-only manuals Before appealing the request for an overpayment or appealing a denial, providers and staff should first verify the claim was coded and billed correctly. Second, staff should review the internet-only manuals website, which includes operating instructions, policies and procedures that cover CMS policies based on statutes, regulations, guidelines, models…