The year 2015 brought the end of the much-maligned Sustainable Growth Rate (SGR), sometimes known as the “doc fix.” The SGR established limits on Medicare reimbursement for physicians, and each year, physicians and those lobbying on their behalf were forced to stave off drastic cuts to their payments. “The SGR was Congress’s attempt to control…
Search results for: Primary care

Diagnosis of Acute Gouty Arthritis Obscured by Anchoring Bias
A 56-year-old African American man presents to the emergency department with polyarthralgias and a fever of 103ºF. One month prior to admission, he presented with right knee pain and swelling. Blood cultures grew S. epidermidis. He was treated for presumed septic arthritis complicated by MSSE bacteremia. He was treated with meropenem and a prolonged course…

Weakness, Fatigue Can Signal Underlying Rheumatologic Disease
As clinicians, we are familiar with pain, stiffness and soreness—subjective nouns that define our métier. These helpful words serve as signposts that direct us along the path to the proper diagnosis. Consider the young man with a stiff, sore back (a case of ankylosing spondylitis?) or the postpartum woman experiencing newly painful, stiff and sore…
Rheumatology March Coding Corner Question: Pediatric Rheumatology Consult
A 13-year-old black male, described by his mother as a very active and energetic child, is referred to a pediatric rheumatologist. His chief complaint is muscle pain in both legs, which he has experienced for the past three weeks. His mother is a patient of an adult rheumatologist at this clinic and is quite concerned….

What Rheumatologists Wish Their Colleagues Knew: Managing Skin Disease & Comorbidities
From treating rashes to uncovering a case of osteoarthritis, dermatologists and rheumatologists can work together in a variety of ways to improve patient care, says Joseph F. Merola, MD, MMSc…
Quality Update Reporting Changes under MACRA
With the termination of the Sustainable Growth Rate formula through the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), clinicians who participate in Medicare Part B will now be reimbursed through a new payment model called the Quality Payment Program (QPP). How It Works The QPP rewards the delivery of high-quality patient care via…

Rheumatology Research Abstracts Highlight Treatment for Hand OA, Risk of Depression in Lupus and More
WASHINGTON, D.C.—What do treating hand osteoarthritis (OA) in the primary care setting, high financial strain and risk of depression in patients with lupus, prolonged sitting and cardiovascular disease, and sex-specific treatment after total hip arthroplasty have in common? They were all topics presented during a session titled ARHP I: Exemplary Abstracts at the 2016 ACR/ARHP…

The ACR’s 2015 Workforce Study Reveals Gap Between Rheumatologist Supply, Patient Demand
WASHINGTON, D.C.—In the next 15 years, it will be increasingly difficult to provide adequate care for rising numbers of patients with rheumatic diseases due to a severe shortage of trained rheumatology healthcare providers, according to the ACR’s 2015 Workforce Study of Rheumatology Specialists in the United States. The full study is available online, and panelists…

Statins May Protect Against RA
A recent observational study found a link between high-intensity statin therapy and a 23% reduced risk of rheumatoid arthritis. Although further research is needed, researchers note this study “provides robust evidence of a protective effect of high-intensity statins on the risk of RA.”

Medical Paradoxes in Clinic, Lab Should Encourage Physicians to Reappraise Ideas about Health and Disease
Wash your hands. This most basic tenet of proper hygiene has been drummed into our heads for years. It’s an obvious infection prevention activity, yet for years, compliance among physicians and other caregivers has been lackluster. To rectify this matter, regulatory agencies began auditing hospital staff adherence to this axiom of infection prevention. Not only…
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