CHICAGO—ACR leaders described a series of looming legislative and regulatory threats to rheumatologists and their patients—including the proposed collapsing of evaluation and management (E/M) coding and potential changes to step therapy rules—and urged everyone in the field to make their voices heard to quash the proposals. They also recounted recent victories in the policy realm…
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The 2018 ACR/ARHP Annual Meeting Program Preview
Save the date for the 2018 ACR/ARHP Annual Meeting, Oct. 19–24 in Chicago. Connect with your colleagues for an unmatched educational experience featuring exceptional sessions by leading rheumatology experts. The ACR/ARHP Annual Meeting is your gateway to global rheumatology education. With more than 450 sessions—including The Great Debate—the meeting provides boundless opportunities for professional development,…
Pfizer-Lilly Pain Drug Meets Late-Stage Trial Goals
(Reuters)—An experimental osteoarthritis drug developed by Pfizer Inc and Eli Lilly and Co achieved its main goal of lowering pain in a late stage trial, the companies said on Wednesday, potentially offering a safer alternative to opioids. Opioid abuse has reached epidemic proportions in the United States and drugmakers have been looking for less addictive…
Ethics Forum: What to Do with the Inherited Opioid Patient?
A 67-year-old man with a recent onset of diffuse muscular pain and stiffness and an erythrocyte sedimentation rate of 55 is referred to you by his family practitioner. He has a history of non-insulin-dependent diabetes mellitus, but no history of headaches or swollen joints. He has chronic back pain, has had two surgeries and was…
Anticonvulsants Unhelpful for Low Back Pain
NEW YORK (Reuters Health)—Solid evidence suggests that anticonvulsants provide no benefit for low back or lumbar radicular pain and a high risk of harm, researchers say. “We started the study because these drugs were increasingly being used for low back pain and radiating leg pain, without the support of strong evidence of effectiveness,” principal investigator…
Can Rheumatologists Get More Systematic about Psychosocial Care?
A recent position statement by the Society of Behavioral Medicine (SBM) concludes that patients with persistent pain need better access to psychosocial care in all healthcare settings.1 The SBM offers 10 health policy recommendations for improving such access, including removing system-related barriers, providing referral tools, reimbursing for evidence-based psychosocial approaches, prioritizing generalist-level and specialist pain…
Prescribing Hope: The Placebo Effect Endures
“Wait. I can explain.” One could imagine this phrase coming up under many conditions in daily life. When I first became a physician, however, I would never have expected to use this phrase in my clinic. In medical school, I was taught the importance of dialogue in establishing a relationship with a patient. Statistics indicate…
Healthcare Providers Should Encourage Exercise for OA Patients
A systemic review supports the ideas that exercise benefits the physical and mental health of patients experiencing pain related to hip and/or knee osteoarthritis (OA). Overall, research indicates that patients who exercised had slightly lower rates of pain and greater physical function, as well as slightly improved self-efficacy and social function…
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…
Patient Satisfaction Scores—Do They Matter?
You see a patient for the first time to establish care for Sjögren’s disease. She complains of dry eyes, dry mouth and diffuse arthralgias. You do not appreciate any synovitis on physical exam. Of note, you are the fourth rheumatologist she has seen during the past year. Toward the end of the clinic visit, she…
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