ROME, Italy—The medical environment is increasingly adapting to the possibilities of optimizing care by individualizing medical treatment and tailoring treatment to disease phenotypes. Data suggest that individualizing exercise therapy, an important treatment modality for rheumatic and musculoskeletal diseases, can help control disease, maximize function, minimize functional barriers and decrease the risk of co-morbidity.1,2,3 Personalizing exercise…
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Mindfulness May Improve Medical Efficacy in Rheumatology Patients
Every day, rheumatology patients live with the realities of having a chronic disease that requires a lifetime of treatment. This knowledge can be an emotional burden, and some people deal with it better than others. Emerging research is showing that those patients who exhibit emotional control are better able to cope and ultimately experience a…
Surgeon Performance Unaffected by Fatigue from Overnight Work
(Reuters Health)—Going without sleep the night before does not affect the performance of doctors doing elective surgery the next morning, according to a new Ontario study that runs contrary to research demonstrating that sleep-deprived physicians pose a hazard to patients. The odds of having a surgery-related problem were 22.2% when the doctor had been treating…
7 Tips for New Rheumatology Fellows
About a year ago, I stuffed all my earthly belongings into my black Volkswagen Jetta and set out on a 10-hour interstate journey. I had just graduated from residency at the University of Kentucky and was headed westward, to Iowa City, for a fresh start as a rheumatology fellow. During the 10 hours I spent…
How to Deliver Difficult News about Patients’ Diagnoses
Telling a patient that he or she has been diagnosed with rheumatoid arthritis (RA), ankylosing spondylitis, fibromyalgia or another debilitating, painful and/or chronic condition can be upsetting for a patient to hear and difficult for a rheumatologist to convey. Given this, it’s important to prepare for the appointment. “Take a few minutes beforehand to contemplate…
The ACR’s State-of-the-Art Clinical Symposium: Experts Discuss Jakinibs, Osteoarthritis, Membranous Lupus Nephritis
CHICAGO—With the approval of the Jak inhibitors (i.e., jakinibs) tofacitinib and ruxolitinib—and others being investigated—rheumatologists need to arm themselves with an understanding of these drugs so they can think critically when evaluating them and deciding how to use them, said John O’Shea, MD, chief of the Molecular Immunology and Inflammation Branch of and scientific director…
Tips for Treating Insomnia in Rheumatology Patients
Chronic insomnia is a common complaint for patients with rheumatic diseases and conditions. In fact, sleep disturbances are among the most common symptoms of both fibromyalgia and rheumatoid arthritis (RA), with more than 50% of chronic pain patients reporting sleep disturbances. Pain combined with insomnia can lead to a vicious cycle, says Ruth Gentry, PhD,…
Institute of Medicine Recommends Changes in Graduate Medical Education
Questions, concerns and spirited debate have surrounded the Graduate Medical Education (GME) system for decades. The program that trains nearly 120,000 physicians per year is under constant scrutiny.1 Changes to the political landscape, combined with ongoing efforts by health industry payers and regulators to squeeze inefficiency out of the system, have kept the GME in…
How to Handle Conflict in Physician–Patient Relationships
Studies suggest that physicians rate between 10 and 15% of patient visits “difficult.”1 This is important for a variety of reasons: Patient satisfaction is a frequently measured parameter, and poor interactions may lead to bad ratings. Personal satisfaction on the part of the provider is also an issue, and frustrating interviews can leave the physician…
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Redefined
A report from the Institute of Medicine that gives new diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and recommends a new name for the disorder received mixed reviews from rheumatologists and other physicians.1 “Diagnosing ME/CFS often is a challenge … the new diagnostic criteria will make it easier for clinicians to recognize and accurately…
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