In a December 2019 editorial in the Journal of the American Medical Association, the implications of diagnostic error were explored through the story of two parents, both medical professionals, who sought a diagnosis for their sick child.1 Their son saw specialist after specialist and underwent repeated procedures, but for years was left without an explanation…
I have always been dissatisfied with the apparent dichotomy between researchers and clinicians; this is a false divide. Yes, research includes laboratory-based investigation, clinical trials, and retrospective and prospective studies of disease entities, among other pursuits. However, clinicians also contribute to research by sharing clinical data and through observations of their patients. Clinicians’ daily contributions…
A 61-year-old Caucasian woman with a history of seropositive rheumatoid arthritis (RA) was hospitalized for a several-month history of progressively worsening left ankle pain and swelling. She had been unable to bear weight on her left leg for several days and did not notice improvement in symptoms with 20 mg of prednisone daily, which she…
Advocacy efforts on access and workforce issues in Florida are discussed.
As useful stand-ins for biologics targeting a range of inflammatory diseases, biosimilars have made significant inroads across Europe as less expensive alternatives. Denmark, for example, realized a cost savings of 64% after instituting a mandatory national switch from the originator infliximab to its biosimilar counterpart. In the U.S., however, a considerably smaller fraction of rheumatologists…
Ageism is defined as stereotyping, prejudice or discrimination against individuals on the basis of their age. According to the American Medical Association (AMA), 43% of all physicians and surgeons are 55 or older. Specialists are, on average, older than primary care doctors. In addition, around 30% of the current U.S. population is older than 55,…
As state rheumatology societies go, the Nebraska Rheumatology Society (NRS) is one of the new kids on the block. Established two years ago, the NRS hopes to involve all 27 rheumatologists across the state. Marcus Snow, MD, a rheumatologist at the University of Nebraska Medical Center (UNMC), Omaha, says the state’s rheumatologists are spread across…
Telerheumatology—which refers to the application of electronic communication technology to clinical encounters from a distance between rheumatologists and their patients—has the potential to extend a workforce projected to experience significant shortfalls, making it more accessible to more patients. Multiple barriers that stood in the way of taking full advantage of this promise are now down—at…
The Medicare statute states that items and services provided to beneficiaries must be “reasonable and necessary” to qualify for reimbursement. Although the Medicare program determines in specific cases whether an item or service is reasonable and necessary, it also issues policies, called coverage determinations, to instruct Medicare Administrative Contractors (MACs) what to reimburse providers for….
A 17-year-old girl presents to the pediatric rheumatology clinic for follow-up of recently diagnosed systemic lupus erythematosus (SLE) characterized by class IV lupus nephritis, photosensitive rash and antiphospholid antibody positivity. She is currently being treated with prednisone, mycophenolate mofetil, and hydroxychloroquine. She is accompanied by her mother, who has been very involved in the patient’s…