“That’s a great case. Why don’t we write it up?” It’s a question I’ve heard many times throughout medical school, residency and fellowship. It’s typically intended to be more of a politely worded request than a rhetorical question. We must acknowledge that the process of writing, editing and submitting a case report is onerous, but it…
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Rheumatology Coding Corner Answer: Coding & Billing Basics
Take the challenge. 1. D: All of the above Rationale: Per CPT, if time spent counseling and/or coordinating care dominates the session, then total time must be documented; greater than 50% of the time must be for face-to-face counseling and/or coordinating care, and must be documented as such. Additionally, the extent of the counseling and/or…
The ACR, ARHP Develop National Research Agenda for 2016–2020
Since 2005, the ACR’s Committee on Research has been responsible for advancing the research goals of the organization and providing leadership in research and research training in rheumatology via the ACR’s Research Agenda. The ACR Research Agenda is designed to address critical areas of research in rheumatic diseases, including the need for new technology, new…

Research Provides Insight into Impact of Microbiome on Health, Rheumatic Disease
The microbiome comprises diverse microbial flora, including bacteria, viruses and fungi, that live on mucosal surfaces, predominantly the skin and digestive tract. Microbes evolved billions of years prior to the development of modern Homo sapiens 200,000 years ago; we have always existed with their ubiquitous presence. Despite this, the first microbe was not visualized until…

Opinion: Politics Should Not Trump Science in Medicine
I tell my patients there are three types of science: 1) investigative science, which sometimes gets it right; 2) science in the courtroom, which is junk science; and 3) science in Washington, D.C., which is political science. Our decisions are based on art and science; our patients’ medications are brought to market based on science….

Biosimilars Debate Heats up over Cost Savings, Safety Concerns
After years of speculation about potential cost savings and debates on safety, biosimilars are about to step onto the stage of rheumatic disease treatment. On Feb. 9, the Arthritis Advisory Committee of the U.S. Food and Drug Administration (FDA) met in Washington, D.C., and recommended the approval of CT-P13, a proposed biosimilar to infliximab (Remicade),…

Diagnostic Imaging in Patient with Chronic Left Ankle Pain: Findings
Radiographic imaging showed circumferential soft tissue swelling of the ankle with a soft-tissue density seen in the tibiotalar and posterior subtalar joints, as well as a large, lobulated effusion. MRI of the left ankle shows cystic changes within the talus and first cuneiform bones, as well as a lobulated abnormal soft tissue density with low…

Tips for Selecting Best Job Candidates to Fill Positions, Avoid Turnover
As much as 80% of employee turnover can be attributed to bad hiring decisions, the Harvard Business Review reported.1 And turnover costs are high—one report estimated them to be 100–300% of the base salary of a replaced employee (with 150% commonly cited).2 Given this, the importance of hiring the right employees can’t be underestimated. So…

2015 ACR/ARHP Annual Meeting: Cellular Triggers in Inflammatory Disease
SAN FRANCISCO—What factors help determine whether or not inflammation resolves, leading to healing, or becomes chronic, leading to disease and tissue destruction? A number of important cells, including toll-like receptors, mast cells, anti-citrullinated protein antibodies, complement and interferon, all play their own role in this process. By understanding how they act in innate and adaptive…

Ethics Forum: Pediatric Vaccination Refusals Raise Challenges for Physicians
The boy who could not walk: S.L. is a previously healthy 10-year-old boy who has not walked for three months. Physical examination reveals swollen wrists, knees, ankles and several toes. There is reduced hip range of motion and flexion contractures of both knees. He can stand with assistance, but is unable to take a single…
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