As physicians, ethical challenges are a certainty for us. Some can be spotted easily and avoided, but what do we do when the choices are not obvious, and a path isn’t clear? We must trust our tools to fashion a way forward. Today, we discuss some of today’s most relevant moral dilemmas with the Chair of the ACR Ethics Committee, Dr. Kelly Weselman. We’ll touch on the balance between patient autonomy and medical recommendations, navigating the complexities of access to care and treatment costs, and managing conflicts of interest. At the bottom of the show, we explore the evolving ethical landscape that is influenced by technological advancements and the increasing availability of information. 

Master rheumatologist, Dr. Philip J. Mease, joins us for a deep dive into psoriatic arthritis (PsA). Dr. Mease explains how to diagnose PsA in patients, the latest treatments, his insights on evaluating joint pain, the role of enthesitis and axial involvement and how to differentiate between inflammatory and non-inflammatory causes of joint pain in those with PsA. This was an enlightening discussion with a master physician that we know you’ll enjoy! 

To know where you’re going, you need to understand where you’ve been. This week, we asked Adam J. Brown, MD, the host of the Rheumination’s podcast, to share with us how understanding the evolution of rheumatology informs his clinical observations. Dr. Brown brings us to the founding of rheumatology and covers the major milestones, discoveries, the ground-breaking pioneers and how this bold legacy has shaped the current state of our field. 

This week, we explore what the field of physical therapy can offer to our patient’s care plan. We examine the role of the physical therapist for our patients, the optimal time for a referral, specific interventions, the role of patient education and the importance of communication between rheumatologists and physical therapists. Our guest, Dr. Yasser Salem, a distinguished professor, program director, and active researcher, with over twenty years of experience as an educator, lends insight to the challenges physical therapists face, recent advancements in the field, physical therapy’s future in rheumatology and advice for those looking to join the field. This episode is our second installment in our series with ARP (you can find our latest here) 

Is there a future for AI (Artificial Intelligence) in Rheumatology? Technologies such as Chat GPT and Google’s Gemini are already reshaping the landscape of medicine. In this discussion, we explore its current impact, particularly in disease diagnosis within fields like radiology. We also delve into its potential: AI's promise to revolutionize personalized medicine, enhancing how patients manage rheumatic diseases, and its role in advancing remote patient monitoring. Additionally, we address critical limitations, including concerns around privacy, security, and ethical considerations, particularly in the context of employing large language models. 

By now, you likely have heard about CAR-T Cell therapy, but what exactly is it? Today, we dive headlong into this topic with Dr. Max Konig. We cover how this therapy works, how CAR-T Cells are made and administered to patients. We discuss the risks associated with this type of therapy, the side effects and their management. Lastly, we’ll discuss the rheumatic diseases amenable to CAR-T therapy, those that are not, the costs and ethics involved and what the future may hold for it in rheumatology. Enjoy! 

Internationally renowned Lyme Disease clinician and researcher, Dr. Allen Steere, joins us for a discussion on Lyme Arthritis. Dr. Steere explains the history of this disease, the historical identification of the borrelia spirochete which causes it, how Lyme Arthritis manifests and presents (including why severity can be vary greatly in patients) and explore the current challenges in its diagnosis. We also cover treatment and antibiotic therapies for the disease, what post-treatment syndromes are, how to treat them and how understanding Lyme Arthritis has improved our knowledge of other diseases, such as rheumatoid arthritis.  

Expert researcher and clinician, Dr. Elana Bernstein, is our guest this week as we dive into lung disease brought on by Systemic Sclerosis (SS). We discuss symptoms, diagnosis, how systemic sclerosis affects the lungs, including pulmonary hypertension and interstitial lung disease. Dr. Bernstein, who has dedicated her career to improving patient outcomes in systemic sclerosis, explains her approach to screening for lung disease, plus the latest research and questions that need to be answered. 

This week, Dr. Hausmann takes on Ultrasound in Rheumatology, exploring its use in the field and diagnosing diseases such as Inflammatory Arthritis, Crystaline Arthropathy and Vasculitis. Dr. Minna Kohler, Founder and Director of the Musculoskeletal Ultrasound Program at Massachusetts General Hospital, joins us as our guest. Dr. Kohler discusses how Ultrasound can help therapeutically, what it's like working in an MSK Ultrasound clinic, plus how one can become trained in the use of Ultrasound, what the patient experience is like, the controversies surrounding the use of Ultrasound in rheumatology and what the future holds for it in our field. 

Join us this week as Jon meets with a truly influential woman in the medical field, Dr. Elizabeth Ang, being one of the first pediatric rheumatologists in the Southeast Asian region to receive pediatric rheumatology training and is the Co-Convenor of the Paediatric Rheumatology Special Interest Group of APLAR (Asia Pacific League of Associations for Rheumatology). Beyond this, and so that children with rheumatic disease in the region have the opportunity to be diagnosed and treated, Dr. Ang trains local doctors and shares her knowledge and experience with them in Cambodia, Vietnam, Indonesia and Myanmar. In this episode she and Dr. Hausmann discuss Singapore’s healthcare system, access to biologics, cultural barriers to treatment and much, much more.