In medicine, as in all other areas of human endeavor, we cannot really understand where we are if we don’t understand how we arrived here. American rheumatology traces its origins nine decades back to Europe, when the International Committee on Rheumatism was founded by Jan van Breeman in 1925 at a European meeting of medical…
Musculoskeletal (MSK) ultrasound is a valuable imaging modality for the practicing rheumatologist and provides an efficient tool with high diagnostic value in the evaluation of patients with musculoskeletal complaints. The use of MSK ultrasound has evolved in the U.S. due to the emergence of less-expensive, portable ultrasound units, which provide high-quality gray-scale and power Doppler…
On any Thursday from 7 p.m. to 8 p.m., you can find Robert H. Shmerling, MD, playing tag, basketball or even roughhousing with a group of children at Second Step, a transitional living program that offers victims of domestic violence in the Boston area a safe place to live and opportunities to go back to…
In June 2014, 10 members of a church group returned to St. Louis from Haiti, where they had contracted chikungunya virus (CHIKV), a mosquito-transmitted alphavirus previously unknown in the Western hemisphere that produces inflammatory arthritis symptoms. Because CHIKV-related arthritis mimics seronegative RA, a group of clinicians, immunologists, virologists and geneticists at the Washington University in…
Physician burnout is high and climbing. A 2015 report published by Medscape showed that nearly half (46%) of physicians surveyed responded that they were experiencing burnout; that number is up from 39.8% reported in a similar survey in 2013.1 These physicians experience the tell-tale signs of burnout: loss of enthusiasm for work (or emotional exhaustion),…
Updated Oct. 22, 2015 (revised to delete inaccurate statistics) The cold, hard facts: This year’s rheumatology fellowship applicant pool resembles those of prior years. It is extremely diverse; every continent is represented, save Antarctica. It is somewhat larger, due in part to the growing influx of graduates from the cluster of Caribbean-based medical schools, where…
It takes a great deal of time and money to produce clinical practice guidelines for rheumatic diseases. No matter how well a treatment inhibits inflammatory cytokines, it won’t lower disease activity without one essential factor: patient compliance. “You can’t propose a treatment algorithm in your research that no patient would actually use,” says Veena Ranganath,…
We all know that completely different medical conditions can create the same effects on our patients’ work lives. That is, from the employer’s purely administrative standpoint, an absence is an absence regardless of its cause. Even medical care professionals react differently to similar effects rendered by completely different circumstances. A Personnel Crisis Let me give…
William Robinson, MD, PhD, first became interested in rheumatology in medical school when he started working with a rheumatologist, as well as several other rheumatology mentors. After completing his residency, he joined the rheumatology fellowship program at Stanford University Medical Center, Palo Alto, Calif., where he earned support for his research from the Rheumatology Research…
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…