Consults in Cars

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In this episode of Dialing for Doctors (aka, Tales of Telehell), we consider a growing subset of telehealth seekers connecting from their cars. This has happened several times and it always catches me surprise. While I've had "live" televideo visits with patients walking the dog, waking up in bed, and from the waiting room of another doctor's office, consults in cars is about the nuttiest. What is the patient's role in telehealth?

Zoomatology – Present in Absentia

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Are you a zoomatologist or a doomsatologist? Zoom has replaced the meeting, the teleconference or the board meeting. If your old meetings were bad, then your replacement zoom meetings will also be bad, if not worse. Largely because you have failed to master the medium. Here are the new rules of Zoom.

20,21 Whatever it Takes

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Amazingly, we made it through 2020, a most forgettable year.

Life was great in the first 3 months of 2020, and then COVID hit the fan and a pandemic steamroller derailed life as we knew it.

Best of 2020: My Experience as a COVID19 Vaccine Trial Participant

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I have been an investigator for many clinical rheumatology studies over the past two decades but have never been a study subject until now. On October 31, 2020, I enrolled in the phase 3 trial of the Pfizer/BioNTech mRNA vaccine against SARS-CoV2 (protocol C4591001). Here's my experience.

Best of 2020: Some Good Things, During the Time of COVID-19

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It is not hyperbole to acknowledge that the COVID-19 pandemic has changed the world, inflicting pain and suffering to many, and inconvenience to all. As everyone struggles to make it through these difficult times, it might be worth pointing out some small silver linings that have emerged despite this pernicious dark cloud.

Best of 2020: Wisdom for New Rheumatology Fellows

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Congratulations on choosing the greatest profession, one equally dedicated to both science and patient care. You are now part of a guild that will support you and anticipate your success. Rheumatology needs you to be a big thinking, futuristic problem-solving practitioner who will lead and learn, research and teach. Here are my words of wisdom for aspiring MSK phenoms.

Best of 2020: Steroid Poker

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It began as many cases do: an ill patient, in the ICU, with signs and symptoms across several body systems, yet no clear unifying diagnosis on admission. With things stabilizing, the internal medicine hospital team on which I was serving as hospitalist that week assumed care of the patient. As the case unfolded – pulmonary infiltrates that could be hemorrhagic, renal dysfunction with proteinuria – rheumatic diseases rose in the differential. When serologic studies and other data suggested GPA rather than glomerular basement membrane (GBM) disease or other possibilities such as infection, it seemed the right time to act. And that is when a game of what I call “steroid poker” began.

Best of 2020: Goodwill Wednesday

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Business as usual, Wednesday morning, as I quickly stop at 7-Eleven for my morning coffee and it all begins. A nice stranger holds the door open for me; I reach for a carton of milk for someone unable to; the cashier skips the 2 cents on a $2.02 bill (with a smile). What transpired in a quick five minutes was a series of random, unrelated, unprovoked acts of kindness. Blatant politeness, sincere smiles, compliments between strangers and lots of open doors. This made me think.

My Experience as a COVID19 Vaccine Trial Participant

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I have been an investigator for many clinical rheumatology studies over the past two decades but have never been a study subject until now. On October 31, 2020, I enrolled in the phase 3 trial of the Pfizer/BioNTech mRNA vaccine against SARS-CoV2 (protocol C4591001). Here's my experience.

Telemedicine: What's Changed and What Needs to be Addressed?

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Along with our patients, we've spent the last several months adapting to telemedicine. Following is an update on legislative changes and uncertainties, a look at the care gap that may still exist, and examining the trajectory of telemedicine after the initial rapid growth spurred by COVID-19.

Rheuma-Yogi-ology

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Since the start of the pandemic, my emotions have swung like the pendulum of the hydroxychloroquine efficacy/inefficacy for COVID-19 debate. Stress has always been a part of my life, but it magnified with the recent events in our world. Dr. Lenny Calabrese had cited the benefits of mindfulness meditation to improve immunologic health and sharpen mental acuity. I had seen benefits in my patients, but never could do it myself. How can people meditate and strike a pose when there is so much to worry about?  Stress-eating seems so much more comforting! 

Wisdom for New Rheumatology Fellows

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Congratulations on choosing the greatest profession, one equally dedicated to both science and patient care. You are now part of a guild that will support you and anticipate your success. Rheumatology needs you to be a big thinking, futuristic problem-solving practitioner who will lead and learn, research and teach. Here are my words of wisdom for aspiring MSK phenoms.