Many reasons exist to strive for high patient satisfaction, including those related to maintaining certification requirements, risk management, reimbursement and simply having a competitive practice, but the most important one is that by achieving high patient satisfaction, you will find that your patients will be more motivated and more engaged in their individual care, says…
The following summary regarding use of tacrolimus (TAC) in lupus nephritis highlights a number of debatable points. Although the role of TAC in lupus nephritis remains unproved for North American populations, it might be an excellent option in some clinical situations. These situations include lupus flare during pregnancy and also for lupus nephritis when the…
CPT: 99213, 89060 ICD-10: M10.072 Coding Rationale This is an established outÂpatient visit. The encounter is coded as 99213 because it included: History—Expanded problem-focused history. The history of present illness was brief, the review of systems was extended and the past medical and social history was documented. Examination—Detailed. There were seven organ systems examined. This…
A 55-year-old female patient returns to the office with complaints of gout pain. She is complaining of swelling and a burning pain in her left toe. She has been taking an over-the-counter NSAID to treat the pain, but this has done little to alleviate it. This is her second flare this year. The patient denies…
Heraclitus of Ephesus (c. 500 BC) is credited with the saying, “The only constant is change.” Now, centuries later, change is meteoric, and especially in healthcare and health policy, the pace of change is relentless. Rheumatology and other specialties continue to face challenges that threaten the ability to deliver compassionate, competent care to patients. The…
Inflammation in the knee was found to be associated with development of pain sensitization in recent research with a cohort from the Multicenter Osteoarthritis Study (MOST). This research finding may indicate that targeting of inflammation could help reduce pain severity in knee osteoarthritis (OA). Tuhina Neogi, MD, PhD, says that her and her colleagues’ research,…
Picket Lines: June 27 was marked on my calendar as the day to watch. No doubt the union organizers shrewdly selected it to be their strike day because of its proximity to July 1, an auspicious date for teaching hospitals, when rookie interns and residents anxiously assume their heightened roles of responsibility within the medical…
Case A 17-year-old girl returns to the rheumatology clinic for scheduled follow-up for systemic lupus erythematosus (SLE). She is accompanied by her mother and father. She has a history of autoimmune cytopenias and Class III lupus nephritis. She has responded well to treatment with mycophenolate mofetil and hydroxychloroquine and was successfully weaned off of prednisone…
When I started my rheumatology practice 40 years ago, it quickly became apparent that many referrals of presumed polymyalgia rheumatica (PMR) patients and presumed giant cell arteritis (GCA) patients were the recipients of devastating side effects from long-term corticosteroid (CS) use that could not be discontinued due to prompt recurrence of inflammatory phenomena. It was…
LONDON—From optimizing responses to methotrexate, to the efficacy of biologics, to the need for imaging in assessing remission, the literature, as ever, has been lively with explorations of pressing topics in the treatment and management of rheumatoid arthritis. Josef Smolen, MD, chair of rheumatology at the Medical University of Vienna, reviewed many of the highlights…