When you google your Rheumatologist, do you want to see Tie & Suit?
By Dr Irwin Lim, Rheumatologist
The staff photos on our BJC Health website were taken in-house for convenience and definitely need updating (check out photos of the doctors, warts & all). We’re going to get professional shots but before that, we need some feedback from you.
Might seem a little trivial but what we wear has become a debated topic! First impressions are supposed to matter.
Our internal “debate” has raised a few differing opinions (these aren’t mine):
Opinion 1:
It’s more classy <for> Everyone <to be> dressed in suit in their photos. That is what the general public perception is of specialists and I have raised this point so many times but no one agreed……Image is everything and a good image sells.
Opinion 2:
..doctors need to dress up and look like what they perceive to be…
Opinion 3:
My initial thought is that the tie and full suit makes you look like ….medical specialists who look like they could be working in a law firm in the middle of the financial district.
Some of you long term readers may recall my thoughts on this. Read “Am I a better doctor if I wore a tie?“.
But, I’m happy to be corrected.
While you may not necessarily be representative of the patients who visit our rooms, you are probably representative of people who google their doctors and who check out their website either prior or after a visit.
Given that we all want to make a good impression, even on a website, your opinion does matter.
What do you think? When you google your rheumatologist, do you want to see him/her in formal attire?
If it’s a male, does he have to be in suit and tie to help that patient/doctor relationship?
Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.How does Arthritis complicate being Intimate?
By Dr Irwin Lim, Rheumatologist
Barry, a regular reader of this blog, emailed me this week with a range of suggestions for blog posts.
Among those, was a suggestion for me to write about the effect of a disease on a patient’s sex life and measures to deal with this.
I emailed Barry saying that I didn’t have any particular expertise in the topics he suggested.
I definitely don’t have expert knowledge regarding how patients with arthritis deal with their sexuality, either the actual mechanics of the physical act of being intimate or their desire for sex or even, the effects of medication on these.
Since that email, I’ve been mulling over this topic of sex and intimacy. I must admit it’s not something I bring up or try to discuss in a consultation. I doubt many rheumatologists would, but I am happy to be corrected.
The closest I have come to discussing this would be a couple of cases of impotence when we (the patient & I) were wondering if their medication was implicated, and a particular case of a patient with sciatica who was too scared to let her husband know that their intimate moments would flare her pain.
I do mention sex when discussing the need to avoid pregnancy while being on certain medication, with the most common occasion being my spiel before prescribing Methotrexate. But, that’s typically in the context of using contraception.
So, it’s dawned on me that I’ve basically not broached the subject of sex and intimacy in any meaningful way with my patients.
Can you share your thoughts or ways you have coped? Has your rheumatologist been better at helping you with this? Where do you go for support/information?
Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.Help improve the Email sent to “introduce” patients to Arthritis
By Dr Irwin Lim, Rheumatologist
I thought I would share some progress we’ve made since Flora, our Rheumatology Care Coordinator joined us.
Flora’s role (explained here) includes helping patients adjust to the diagnosis of a chronic arthritis. She has created some introductory emails to send to patients who have just been diagnosed with Rheumatoid Arthritis, Ankylosing Spondylitis and Gout. We’re working on more, but here’s an example of the email being sent:
(I know I feature heavily in the linked content but it’s hard getting the other rheumatologists to shift from their camera & social media-shy state!)
Dear Irwin,
You recently saw Dr Herman Lau and was given the diagnosis of Rheumatoid Arthritis.
By way of introduction, my name is Flora Wong. I am your Rheumatology Care Coordinator. My role is to assist you with any queries you may have regarding your diagnosis. Receiving a diagnosis of Rheumatoid Arthritis may be a stressful and difficult time and it is understandable that following a session with our specialists, you may have additional queries once you have had a chance to absorb and consider the information discussed. My aim is to facilitate and guide you through this journey further to your meeting with your doctor.
Below are links to further information about your diagnosis.
- BJC Information on Rheumatoid Arthritis
- Short videos explaining certain aspects of Rheumatoid Arthritis
Our rheumatology specialists also maintain a blog about different Rheumatological disorders which you may find helpful.
Please do not hesitate to contact me should you have any further queries. My contact details are below.
Kind Regards,
Flora Wong
Rheumatology Care Coordinator
Chatswood +61 2 9413 2979 | Brookvale +61 2 9939 1065 | North Parramatta +61 2 9890 7633
Visit bjchealth.com.au | Like us on Facebook | Follow us on Twitter | Read our Connected Care Blog
Arthritis requires an integrated approach. We call this, Connected Care.
What do you think? Is this something useful, and if so, how can we improve it?
Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.
Rheumatoid: You must stop smoking!
Image courtesy of scottchan / FreeDigitalPhotos.net
By Dr Irwin Lim, Rheumatologist
I was discussing rheumatoid arthritis management with a bunch of colleagues, and we were discussing various peculiarities and relative properties of the biologic medications.
At some stage, one rheumatologist mentioned that she finds herself spending more and more time addressing smoking cessation.
Patients with Rheumatoid Arthritis die from heart attacks and vascular complications.
This is well known, and the good news is that better disease control reduces the risk of this. In addition, TNF inhibitor therapy reduces this risk of dying from cardiovascular causes more than the traditional DMARDs.
But we can do more. Weight loss and improved nutrition, increased exercise to improve fitness, treating blood pressure, et cetera.
Often, the hardest nut to crack is SMOKING.
Smoking is not good for Rheumatoid because:
- It acts as a trigger leading to the disease
- It leads to more active disease
- It reduces the effectiveness of Methotrexate
- It reduces the effectiveness of TNF-inhibitor therapy
And by the way, if you didn’t already know, smoking does cause lung damage, increases risk of cancer, and greatly increases the risk of strokes and heart attacks.
I remarked to this very caring and competent rheumatologist that I wasn’t very good at getting my patients to stop smoking.
If you’re a smoker, what can I say to you to make you stop? Because, you really do need to.
Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.8 reasons why rheumatologists should collect patient self-report data in routine clinical care
By Dr Irwin Lim, Rheumatologist
I freely admit that I don’t. Not yet.
This is an open discussion I’m having with myself and my team. We should collect this patient data, and I lean towards the simplicity of the RAPID-3 (read about & download it here).
The problem is the logistics of actually handing out and getting this questionnaire filled in BJC Health’s particular setting. Our rooms are frequented by many more patients that those seeing the rheumatologists. Our multidisciplinary, multi-practitioner setting means we have to think a little more carefully about introducing a global initiative due to the burden on the administrative staff & the different relevance to different subsets of patients.
But that’s for us to work out.
Collecting patient self-report data is useful because:
- The data patients report correlates significantly with the data doctors collect – joint counts, ESR, and X-ray changes
- It is more reproducible than joint counts, lab results and X-ray scoring systems
- It’s as useful as measures such as the ACR20/50/70 or DAS used in clinical trials
- It’s very relevant to the patient and their families
- It better predicts work disability, premature death, costs of the disease, the need for joint replacement
- It saves time for patient and doctor
- The data documents disease status and provides a measurement that will allow for comparison from one visit to another
- It should help your rheumatologist to be a more effective and hopefully, understanding doctor
I’m a fan. It’s going to happen.
I’d really love to hear your experience with using patient questionnaires, either as the rheumatologist or as the patient.
Dr Irwin Lim is a rheumatologist and a director of BJC Health. You should follow him on twitter here. Arthritis requires an integrated approach. We call this, Connected Care. Contact us.Follow Us!
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