A 65-year-old established female patient returns to the office for a follow-up visit for her diagnosis of fibromyalgia. She complains of pain, stiffness and swelling in her left hand, elbow and neck that is persistent since her last visit. The pain is considerably worse in the morning. She denies any fevers, cough or dyspnea. The…
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Disease Management Programs Help Patients Cope with Chronic Diseases
For patients living with a chronic disease, such as rheumatoid arthritis or osteoarthritis, learning to manage and cope with the myriad adverse symptoms that accompany these diseases is key to improving quality of life and helping reduce the cost burden of these illnesses on the healthcare system. One important way rheumatologists can help is by…
Institute of Medicine Recommends Changes in Graduate Medical Education
Questions, concerns and spirited debate have surrounded the Graduate Medical Education (GME) system for decades. The program that trains nearly 120,000 physicians per year is under constant scrutiny.1 Changes to the political landscape, combined with ongoing efforts by health industry payers and regulators to squeeze inefficiency out of the system, have kept the GME in…
How to Handle Conflict in Physician–Patient Relationships
Studies suggest that physicians rate between 10 and 15% of patient visits “difficult.”1 This is important for a variety of reasons: Patient satisfaction is a frequently measured parameter, and poor interactions may lead to bad ratings. Personal satisfaction on the part of the provider is also an issue, and frustrating interviews can leave the physician…
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Redefined
A report from the Institute of Medicine that gives new diagnostic criteria for myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and recommends a new name for the disorder received mixed reviews from rheumatologists and other physicians.1 “Diagnosing ME/CFS often is a challenge … the new diagnostic criteria will make it easier for clinicians to recognize and accurately…
Super-Group Physician Practices Offer Benefits, But Raise Concerns
Rheumatologists worried about the future of their private practices might want to consider jumping onto the super group trend that allows physicians and other providers with similar services to team up to share opportunities and minimize financial burdens. The biggest concern for private practice physicians watching the trend but not yet embracing it is fear…
Glucocorticoid Use for Rheumatoid Arthritis Still Sparks Debate
Glucocorticoids: The Debate Continues Déjà vu … In past decades, rheumatologists have seen, heard, practiced and taught much of what has been argued in the “ongoing debate” on the use of glucocorticoids (GCs) in the management of rheumatoid arthritis (RA).1 It is heartening to note that eminent professors have stuck to their premise all these…
Restoration of Sleep Physiology vs. Sedation for Sleep Disorders, Fibromyalgia
Sleep disturbance is an important medical problem, requiring intervention, not simply to reduce latency to its onset, but to ensure achievement of the depth of sleep that has been documented to restore homeostasis and prevent the falls that are responsible for so much morbidity and mortality.1 Sleep disturbance is present in 50% of people over…
Better Evidence Supports Slightly Revised Treat-to-Target Recommendations for RA
NEW YORK (Reuters Health)—A number of recent studies support last year’s update of 2010 treat-to-target recommendations for rheumatoid arthritis (RA), according to the international task force that revised them. Dr. Josef S. Smolen from Medical University of Vienna, Austria, and colleagues updated their 2010 advice based on systematic literature reviews and expert opinion. They left…
Lyme Disease Not Predictor of Long-Term Physical, Mental Health Issues
Lyme disease is often considered a cause of chronic fatigue, pain and other incapacitating symptoms. This assumption stems from analyses of patients who seek retreatment for Lyme disease. However, a new study suggests that Lyme disease is not life altering in the long term for most patients. Specifically, patients with culture-confirmed Lyme disease have similar…
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