As those new medications come into widespread use to help control the damage caused by the inflammation of rheumatoid arthritis and prevent progression of the disease, fewer patients may need early, aggressive surgery that preventively removes joint linings, Alderman notes.
But more may eventually need joint replacement or synovial surgery after medications start losing their effectiveness -- and the speed with which they get that surgery may have a lasting impact on how well their hands regain function.
That means communication between specialists will become more important than ever but at the moment, the U-M studies seem to indicate that the two fields aren't talking with each other.
The new paper shows that 67 percent of hand surgeons and 79 percent of rheumatologists had no exposure to the other specialty during their medical training, and only about 10 percent of the physicians worked in combined-specialty hand clinics. And only 62 percent of all the physicians said they communicate with the other specialist treating a patient when they disagree with how a patient's care is being managed by that doctor.
The U-M Medical School is trying to bridge the gap in cross-training, by exposing medical residents in surgery and rheumatology to the other specialty during joint sessions.
All in all, say the authors, patients need to ask about all possible treatment options when they see primary care doctors and specialists, and decide what's right for them based on the level of their sympt
'"/>
Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
25-Jul-2003