Why I love rheumatology: It’s all about inter-professionalism
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This month’s cover story is a roundtable discussing the coordination of care for patients with both ankylosing spondylitis and inflammatory bowel disease, and features commentary from gastroenterologists and rheumatologists, including Miguel Regueiro, MD; Brett Smith, DO; Ashwin N. Ananthakrishnan, MD, MPH, MBBS; Nicole Cotter, MD; Sharon Dudley-Brown, PhD, FNP-BC; and Seyedehsan Navabi, MD. It is a terrific read and reminded me of one of the many reasons that rheumatology is such a terrific specialty — namely, that we have virtually no boundaries.
I often tell medical students, residents and trainees to hold tight to this concept, in career development and professional identity formation, for it will keep you intellectually stimulated and buffer you from burnout and boredom.
Just think about it — although we are musculoskeletal experts, rheumatology is not really organ based, and we have the opportunity to move in so many different directions. Here at the Cleveland Clinic, which I love for its inter-professionalism and lack of silos, we actually have a motto: TAAAU (To Act as a Unit). This means we hopefully think smarter and work better collaboratively than separately.
For tough cases, I rely on my musculoskeletal experts such as Elaine Husni, MD, for triaging and managing cases of complex local-regional rheumatic problems, because of her leadership in working with orthopedists and physiatrists in the Arthritis and Musculoskeletal Center. At the same time, she works with Tony Fernandez, MD, PhD, in the Rheumatology-Dermatology Clinic, which has national prominence. Finally, she is now on the faculty of the Advanced Inflammatory Bowel Disease Fellowship program, founded by Dr. Regueiro, one of this month’s discussants.
Just to name a few more: Rula Hajj Ali, MD, runs our integrative Vascular Neuroinflammatory Clinic networking with stroke neurology, neuroimmunology, neuroradiology and neuropathology, while Cassandra Calabrese, DO, dually boarded in infectious disease, has academic appointments and clinics in both ID and our oncology institute. Carol Langford, MD, who leads our long-standing Vasculitis Center, has cultivated inter-professional care, research and education with so many other groups, including vascular medicine, cardiothoracic surgery, nephrology, pulmonology and, well, I know you get it. Vasculitis has no boundaries.
Finally, as merely one more extraordinary example, the Sarcoidosis Center, attended by our own Tom Ungprasert, MD, is a wonderful mixture of all allied specialties with trained subspecialists in diverse areas, such as Brandon Moss, MD, who is the neuro-sarcoid consultant, and many more.
I know there are many other similar collaborative efforts at large centers and opportunities at other institutions that do this just as well, but my point is that, for budding rheumatologists, there are and should be no boundaries. What about rheum-sports medicine? Or rheumatology in performing arts medicine? I provided care for the Cleveland Ballet for more than 20 years and loved it so much that it stands as one of the highlights of my career in terms of professional satisfaction.
Look at Jim Rosenbaum, MD, as the icon of rheum-ophthalmology, to name one more. You can collaborate even if you are in private practice. I have heard Phillip Mease, MD, urge practitioners to have a virtual rheum-derm clinic, and have a go-to specialist in every area that you can reach by phone, FaceTime or whatever.
Follow your passions, have no boundaries and reinvent yourself every 5 years — that is my prescription for lifelong learning and having fun as a rheumatologist. That’s my take. What’s yours? Share your thoughts with us at calabrl@ccf.org or at rheumatology@healio.com.
- For more information:
- Leonard H. Calabrese, DO, is the Chief Medical Editor, Healio Rheumatology, and Professor of Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer Chair of Clinical Immunology at the Cleveland Clinic.
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