With only 15 practicing rheumatologists in the state, members of West Virginia’s Rheumatology (WVR) Society knew early on they needed a stronger voice to help their patients. So WVR Society President Suzanne Gharib, MD, joined West Virginia’s state medical society, comprising physicians from a range of specialties. “It turns out our state medical society was…
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Ethics Forum: Righting the Wrong Diagnosis
A 54-year-old woman is establishing care in your clinic after retirement of her previous rheumatologist. Your review of her records suggests that she was diagnosed with systemic lupus erythematosus seven years ago on the basis of symptoms of body pain and fatigue, and serologic evidence of positive ANA 1:40 (speckled) and borderline anti-SSB antibody. She…
ACR Past President Dr. Bill St.Clair Is an Avid Duke Basketball Fan
Bill St.Clair, MD, MACR, says one of the most exciting and proudest moments in his life wasn’t earning his medial degree or seeing his first published article on arthritis and rheumatology. Not even close. It was the 1991 National Collegiate Athletic Association (NCAA) basketball semifinal. Specifically, the basketball game between Duke University and the University…
5 Ways to Unlock the Power of Consultation
Think back to your time as a trainee. Do you remember an interaction with a consultant in which you learned something, felt your opinion was heard, were empowered to collaborate with the consulting team and knew you were providing outstanding care? We suspect a number of examples come to mind, regardless of the amount of…
Tips & Tools for Dealing with Bad Patient Outcomes
Bad things happen to good rheumatologists—and to their patients—and can have profound personal and professional consequences for the doctor. Sometimes recommended treatments can have predictable, but devastating, side effects. Even if the rheumatologist does everything right according to evidence-based best practice, patients can still have bad outcomes, even die—with resulting feelings of sadness, anger, guilt…
Neutrophil Extracellular Traps & Their Role in Autoimmunity
Certain medications have been associated for decades with the development of drug-induced autoimmunity. New research published in March 2018 in Arthritis & Rheumatology suggests that NETs (neutrophil extracellular traps) are potentially implicated in the mechanisms that lead to drug-induced autoimmunity.1 Peter Grayson, MD, MSc, head of the Vasculitis Translational Research Program at the National Institute…
Pediatric Rheumatologist Dr. Lynn Punaro Loves a Good Mystery
When Marilynn “Lynn” Punaro, MD, MACR, isn’t working with medical students, seeing patients in the clinic, participating in translational research or performing leadership duties, she’s enjoying a good book—especially a good mystery. This shouldn’t be a surprise. It was mystery that led Dr. Punaro to a career in pediatric rheumatology more than 30 years ago,…
Rheumatology Can Use MACRA to Drive Healthcare Improvements
We have entered the second year of the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act (MACRA) of 2015. It’s no secret that the costs of medical care—17.1% of the U.S. gross national product compared with 9.8% in Great Britain, 10.7% in Canada and 11.6% in France—have become an overwhelming driver for change….
Opioid Refusals: How to Deal with the Angry or Hostile Patient
In July 2017, Todd A. Graham, MD, a practicing orthopedic surgeon in South Bend, Ind., was fatally shot after getting into a heated dispute with a patient and her husband over a requested opioid prescription.1 The murder of Dr. Graham is a tragic example of the potential dangers of physician-patient disagreements. Rheumatology patients often endure…
In Memoriam: Nathan Wei
We are sad to report that Nathan Wei, MD, FACR, passed away March 27 from aggressive cancer. Dr. Wei was a passionate, compassionate, fiercely independent innovator, student and teacher, who carved out his own way of doing things, always in the pursuit of excellent patient care. He was unafraid to embrace cutting-edge medical services for…
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