Earlier recognition may help outcomes in osteoarthritis

Interventions such as exercise and weight loss are more likely to be successful for osteoarthritis if it is detected early.

Osteoarthritis affects millions of Americans, but effective treatments for advanced disease continue to be limited. The Chronic Osteoarthritis Management Initiative, which ACP supports, is looking to change that by encouraging primary care physicians to recognize the problem earlier. That way, experts say, interventions such as exercise and weight loss are more likely to be successful. Our story covers distinguishing osteoarthritis from other types of arthritis, incorporating screening into routine checkups even for younger patients, and choosing among available treatment options.

Increasing emphasis on technology and on reporting requirements has in turn increased the pressure on small physician practices. In an effort to partially relieve the burdens of a changing health care system and maintain a semblance of work-life balance, more physicians have been merging with larger health systems. However, doing so is not necessarily a cure-all. Such a move can mean wholesale changes in the way a physician practice does business, affecting everything from phone systems to appointments to labs and pharmacies. Our story looks at the five key areas that experts say are most important to consider when deciding whether to make the leap: culture, finance, technology, staffing and patient relations.

This issue also features the first installment of a new column, “Doctor as Patient,” written by Pamela Hartzband, MD, FACP, and Jerome Groopman, MD, FACP, best-selling authors of Your Medical Mind: How to Decide What Is Right for You.” The column looks at physicians' thinking as applied to their own health and wellness, based on real stories from readers. Drs. Hartzband and Groopman examine the case of a nephrologist who unexpectedly faced his own mortality, discussing how he came to accept his diagnosis and why physicians are not always the experts when it comes to caring for themselves.

Finally, we've added another new feature called “Crossed Words, “ the first installment of which you can find on this page. These acrostic-like puzzles, by ACP Associate Member Justin Vader, MD, will test your medical knowledge and, we hope, provide a bit of fun. Try your luck!

We'd love to hear from you about our new column, our new puzzles, and anything else that's on your mind. If you have comments, or a story to share for our “Doctor as Patient” column, please let us know.


Jennifer Kearney-Strouse