2 articles - Arthritis FDN and US News and World Report TOP RHEUMY HOSPITALS

[Guest guest]

Felt compelled to share this. I am happy to say my hospital is #16.

Rank Hospital Reputation Score 1 s Hopkins Hospital, Baltimore

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_632\

0180.htm> 52.2 2 Mayo Clinic, Rochester, Minn.

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_661\

1490.htm> 46.6 3 Hospital for Special Surgery, New York

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_621\

2900.htm> 38.8 4 Cleveland Clinic

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_641\

0670.htm> 38.3 5 Brigham and Women's Hospital, Boston

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_614\

0215.htm> 25.7 6 University of Alabama Hospital at Birmingham

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_653\

0304.htm> 23.6 7 UCLA Medical Center, Los Angeles

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_693\

1755.htm> 23.2 8 Massachusetts General Hospital, Boston

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_614\

0430.htm> 19.8 9 NYU Hospital for Joint Diseases, New York

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_621\

2925.htm> 13.1 10 University of California, San Francisco Medical

Center

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_693\

0043.htm> 11.9 11 Duke University Medical Center, Durham, N.C.

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_636\

0355.htm> 11.2 12 Stanford Hospital and Clinics, Stanford, Calif.

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_693\

2330.htm> 11.2 13 University of Pittsburgh Medical Center

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_623\

0029.htm> 10.3 14 University of Michigan Hospitals and Health System,

Ann Arbor

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_644\

0110.htm> 9.8 15 New York-Presbyterian Univ. Hosp. of Columbia and

Cornell

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_621\

0024.htm> 7.3 16 -Jewish Hospital/Washington University, St.

Louis

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_663\

0930.htm> 6 17 University of California, San Diego Medical Center

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_693\

2820.htm> 4.3 18 Hospital of the University of Pennsylvania,

Philadelphia

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_623\

1900.htm> 3.9 19 Northwestern Memorial Hospital, Chicago

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_643\

0545.htm> 3.5 20 University of Washington Medical Center, Seattle

<http://www.usnews.com/usnews/health/best-hospitals/directory/glance_691\

0750.htm> 3.5

Advice from the Top

Top Rheumatology Hospitals Talk

to the Arthritis Foundation

In July, U.S. News and World Report announced the 100 Top Hospitals in

the United States. The fact that they included a separate list of the

Top 20 Rheumatology Hospitals underscores what we already know. That is,

arthritis is one of the most prevalent diseases in the country.

The Arthritis Foundation contacted each hospital to find out the state

of arthritis research and care in the top clinical and research

facilities in the United States. The doctors took time from their

schedules to speak to us about everything from why they are

rheumatologists to where they would invest research dollars.

We also realized that the Arthritis Foundation funds research in every

one of these hospitals. In fact, we fund more than 109 researchers the

top 20 list. They took time to talk to us too.

Why did you choose to be a rheumatologist?

There was (and is) nothing in medicine more interesting and rewarding

for me. To have an opportunity to help people with chronic illnesses,

make every visit count as a step forward in improving their lives,

easing their anxiety, pain and suffering…what could be better? In

practicing the art of rheumatology, one also has opportunities to

gradually come to better understand immune function, its' marvels in

protecting us from the onslaught of innumberable environmental pathogens

and consequences that may come of cell mutations (malignancy). We also

learn how this incredible system remains a work in progress – how it

may still be prone to error or imperfections that allow autoimmune

diseases or malignancies to occur.

S. Hoffman, MD, MS

Harold c. Schott Chair of Rheumatic & Immunologic Diseases

Professor of Medicine, Lerner College of Medicine

Cleveland Clinic

I love the opportunity to treat patients with chronic illnesses. I can

establish a relationship with patients and their families that lasts for

years. There's nothing more satisfying than serving not just as a

practitioner of medicine but also as a trusted friend of an extended

" family. " In addition, being a rheumatologist requires one to

maintain skills in virtually all aspects of internal medicine. And the

research in our field is truly on the cutting edge of medicine!

E. Sack, MD

Professor of Clinical Medicine, UCSF

Director of Clinical Rheumatology, Moffitt Hospital

University of California, San Francisco Medical Center

I was involved in an interesting clinical research project related to

scleroderma heart disease as a medical student. This was my first

introduction to patients with rheumatic diseases, and I was struck by

how little was known about the pathogenesis and treatment compared with

other subspecialties. I view rheumatology as an areas that was both

fascinating and had a huge unmet medical need.

S. Firestein, MD

Chief of Rheumatology, Allergy and Immunology

University of California, San Diego Medical Center

I chose rheumatology because of the breadth of the specialty, the

ability to care for patients with chronic disease and my own research

interests in immunology. I would make the same choice today and because

of the new therapies, I can add the ability to significantly improve the

lives of patients.

S. Pisetsky, MD, PhD

Professor of Medicine & Immunology,

Chief of Rheumatology & Immunology

Duke University Medical Center, Durham, NC

Because it is a field in which you can employ the clinical expertise

from all the subspecialties of internal medicine in the detective game

of taking complex disease presentations and distilling them down to a

single diagnosis and then employing state-of-the-art medications to

improve the quantity and quality of life for your patients.

Stephan A. Paget, MD, FACP, FACR

Physician-in-Chief & Chairman, Division of Rheumatology

Hospital for Special Surgery, New York

What should all people with arthritis know about

communicating with their doctors?

Trust and communication between the patient and doctor continues to be

the most important basic structure that assures optimal health outcomes

and the safe treatment of illnesses.

Stephan A. Paget, MD, FACP, FACR

Physician-in-Chief & Chairman, Division of Rheumatology

Hospital for Special Surgery, New York

Be sure your doctor understands the impact of your arthritis on your

life -- what you can't do that you'd like to. From time to time,

particularly during difficult periods, it is useful to ask a family

member to join you so that your family has a full understanding of the

support that may be necessary to achieve your treatment goals.

Abramson, MD

Chairman of Rheumatology

NYU Hospital for Joint Diseases, New York

Convey as clearly as possible the nature of their symptoms. It is

important to articulate the time course of symptoms, and how their

course has evolved over time. These elements of the patient history are

indispensable to the treating physician in planning an appropriate

diagnostic evaluation and treatment plan.

Antony Rosen, MD

Professor of Medicine, Cell Biology & Pathology

Director, Division of Rheumatology

s Hopkins Hospital, Baltimore land

We are here to help you. Communication and complete honesty are

essential, even when it means discussing what medicines you don't

want to take or what side effects are unacceptable. It is not about

keeping the doctor happy or pleased. It is about improving the quality

of life of our patients.

S. Firestein, MD

Chief of Rheumatology, Allergy and Immunology

University of California, San Diego Medical Center

First, your doctor needs to know what YOU want with regard to the

treatment of your arthritis. Second, e-mail is a great way to

communicate, if your doctor is willing.

Brasington, MD FACP

Associate Professor of Medicine,

Director of Clinical Rheumatology

-Jewish Hospital/Washington University, St. Louis

Patients who are well organized can best transmit the necessary

information to their doctors. If changes in your health occur between

visits to your doctor, write down a concise descrition of what has

happened, and write down the questions you have.

A. Fox, MD

Professor of Internal Medicine, Chief, Division of Rheumatology

University of Michigan Health System

What should all people with arthritis do to best

manage their care?

Become informed and even well educated about your arthritis condition

and its management. That is the first step towards self-management, and

towards becoming a true partner with your healthcare team in taking

control of your disease.

A. Fox, MD

Professor of Internal Medicine, Chief, Division of Rheumatology

University of Michigan Health System

First, everyone (not just arthritis patients) should eat a healthy,

balanced diet. Second, stay fit. I once read a fortune cookie message

that said, `It is better to wear out than rust out.' That is a

great philosophy of life and is especially important for arthritis

patients.

S. Firestein, MD

Chief of Rheumatology, Allergy and Immunology

University of California, San Diego Medical Center

The most important thing is to seek help early and adhere to a treatment

plan they understand and have helped determine. They also must set

treatment goals realistically so they can make informed choices on the

basis of knowledge of risks and benefits.

S. Pisetsky, MD, PhD

Professor of Medicine & Immunology

Chief of Rheumatology & Immunology

Duke University Medical Center, Durham, NC

Become informed consumers of medical care and develop a close,

productive and ongoing partnership with their physician. Maintain a

current list of medical problems and medications, their doses, the

reason that they are taking them and the potential side effects.

Stephan A. Paget, MD, FACP, FACR

Physician-in-Chief & Chairman, Division of Rheumatology

Hospital for Special Surgery, New York

Study their disease, and learn what are realistic expectations from

therapy, as told to them by their doctor. If things are not going well,

consider speaking with your doctor about consultation and exploring new

experimental therapies that are under study an medical centers where

staff and faculty are thought-leaders for their illnesses.

S. Hoffman, MD, MS

Harold C. Chair of Rheumatic & Immunologic Diseases

Professor of Medicine, Lerner College of Medicine

Cleveland Clinic

What is the greatest advancement in arthritis

treatment in the past 10 years?

There is little doubt that the development of biologics (biologic

response modifiers) are the greatest advance probably in the last 50

years. Biologics are protein drugs that modulate the function of the

immune system. Although the first and best known biologics used for

arthritis were those that block the function of the inflammatory protein

called TNF (tumor necrosis factor), biologics are now being used to

treat lupus, psoriasis and vasculitis in addition to arthritis.

B. Elkon, MD

University of Washington Medical Center

I think the greatest advancements have been made in two major areas:

Better understanding of bone biology, with identification of substances

that break down bone, and treatments for osteoarthritis and

osteoporosis. The second area is the development of biologic response

modifiers such as the anti-TNF drugs for inflammatory arthritis, which

have improved the lives of patients with these diseases.

L. Matteson, MD

Professor of Medicine, Division of Rheumatology

Mayo Clinic, Rochester, Minnesota

" Without question, it is the recognition that tumor necrosis factor

alpha (TNF) is a major factor in the pathosphysiology of rheumatoid

arthritis, and that we could make inhibitor agents which could be given

to patients effectively and safely. The lessons: we can figure out what

is wrong in RA and we can develop treatments to fix it. "

Brasington, MD FACP

Associate Professor of Medicine,

Director of Clinical Rheumatology

-Jewish Hospital/Washington University, St. Louis

The greatest advance is the development of biologic therapies that are

specifically targeted to molecules central to the pathogenesis of

rheumatic diseases. The greatest advance is not the development of any

one particular agent, but rather the clinical proof that this approach

works in a powerful way to alter the course of the disease.

A. Fox, MD

Professor of Internal Medicine, Chief, Division of Rheumatology

University of Michigan Health System

The greatest advances in the last 10 years has been the introducation of

the new biological therapies for the treatment of rheumatoid arthritis

coupled with early aggressive treatment.

S. Pisetsky, MD, PhD

Professor of Medicine & Immunology

Chief of Rheumatology & Immunology

Duke University Medical Center, Durham, NC

What advancements do you think we will see

in the next 10 years?

I think that we will develop the ability to accurately predict who will

develop inflammatory and autoimmune diseases, and perhaps non-autoimmune

diseases, such as osteoarthritis, as well. This will then open the

possibility for strategies aimed at prevention, or at least very early

intervention, in disease before it fully develops clinically. I also

think that much progress will be made towards identifying the causes of

autoimmune diseases. Finally, biologic approaches will be applied more

broadly to the full range of rheumatologic diseases, possibly even

osteoarthritis.

A. Fox, MD

Professor of Internal Medicine, Chief, Division of Rheumatology

University of Michigan Health System

New treatment that will reduce steroid dependency and improve the

quality of life for people with systemic lupus erythematoseus and some

forms of vasculitis. Definition of genome patternes that identify who

will respond or have toxicity to several of the therapies for rheumatic

diseases. A new drug for people with gout who are allergic to

allopurinol.

Bevra Hannahs Hahn, MD

Professor of medicine & Chief of Rheumatology

UCLA medical Center, Los Angeles

Disease modifying drugs for osteoarthritis will be introduced that

effectively slow OA disease progression.

Abramson, MD

Chairman of Rheumatology

NYU Hospital for Joint Diseases, New York

For RA, I think we will see clinical research directed to inducing

remission in RA by combination therapy. " For OA, we will see further

refinement in joint surgery.

S. Pisetsky, MD, PhD

Professor of Medicine & Immunology

Chief of Rheumatology & Immunology

Duke University Medical Center, Durham, NC

We'll likely see agents capable of modulating immune system function

by targeting more precise mediators of the inflammatory response. We

almost will certainly have a better understanding of the genetics of

rheumatic diseases.

E. Sack, MD

Professor of Clinical Medicine, UCSF

Director of Clinical Rheumatology, Moffitt Hospital

University of California, San Francisco Medical Center

If you were investing in research, what type of

research would you fund?

Discoveries in complex diseases frequently come from very unexpected

quarters. I think that investing across the breadth of the arthritis

enterprise, particularly in novel areas and in very talented and

promising investigators is likely to generate significant results.

Antony Rosen, MD

Professor of Medicine, Cell Biology & Pathology

Director, Division of Rheumatology

s Hopkins Hospital, Baltimore land

I would invest in pharamcogenetics, novel targeted therapies and

identification of environmental agents that trigger RA, SLE and

vasculitis, as well as vaccine development for some such agents. I also

would invest in methods to finance availability of care for all U.S.

citizens with rheumatic diseases and biomarkers for diagnosis and for

response therapies for any rheumatic disease.

Bevra Hannahs Hahn, MD

Professor of medicine & Chief of Rheumatology

UCLA medical Center, Los Angeles

I would fund genomic and proteomic research, and research into bone and

cartilage biology.

L. Matteson, MD

Professor of Medicine, Division of Rheumatology

Mayo Clinic, Rochester, Minnesota

I would invest in research on new targets to block inflammation and

reduce tissue damage; tissue engineering to repair cartilage, stem cell

research to understand key issues in organ development and regeneration;

and genomics research to understand regulation of gene expression.

S. Pisetsky, MD, PhD

Professor of Medicine & Immunology

Chief of Rheumatology & Immunology

Duke University Medical Center, Durham, NC

One way of answering this question is that the best research should be

funded no matter what questions it addresses. That is, the research that

presents the most compelling and interesting case for funding. Research

is progressing on a broad front in the rheumatic diseases. While

specific research funding programs that target individual diseases are a

very worthwhile, and can catalyse coordinating efforts to understand and

better treat a disease, such as rheumatoid arthritis, funding should not

be confined to any single type of research or specific approach.

Genetics, immunology, systems biololgy, clinical investigation, and many

other approaches, all offer tremendous opportunities.

A. Fox, MD

Professor of Internal Medicine, Chief, Division of Rheumatology

University of Michigan Health System

It would be very valuable to fund research on identifying the

pathophyiological mechanisms that result in joint damage in arthritis.

As the mechanisms of tissue injury are delineated, the key molecules and

pathways involved can be identified. These key molecules and pathways

then become new targets for therapeutic development that will hold

promise for better treatments.

B. Brenner, MD

Chief, Division of Rheumatology, Immunology and Allergy

Brigham and Women's Hospital and Harvard Medical School

Is there any advice or information you want to share?

This is a great new era of investigation in arthritis, which I sincerely

hope will translate into improved treatments and better lives for people

affected with these diseases.

L. Matteson, MD

Professor of Medicine, Division of Rheumatology

Mayo Clinic, Rochester, Minnesota

The Arthritis Foundation needs your support, specifically to expand its

ability to fund important research.

A. Fox, MD

Professor of Internal Medicine, Chief, Division of Rheumatology

University of Michigan Health System

While it is true that many forms of arthritis are related to aging and

are more common among the elderly, it is equally important to recognize

that arthritis and rheumatic disorders can affect persons across the

entire lifespan.

Antony Rosen, MD

Professor of Medicine, Cell Biology & Pathology

Director, Division of Rheumatology

s Hopkins Hospital, Baltimore land

This is truly a revolutionary time for patients with rheumatic diseases.

Never have so many new medications (mostly biologics) been available.

This should provide all patients great hope that the diseases they have

will be better treated in the very near future.

B. Elkon, MD

University of Washington Medical Center

Since rheumatoid arthritis and lupus can increase risk for

cardiovascular disease, patients should be sure that their physicians

focus not only on treating arthritis but also on treatment for

conditions that also increase risk of heart attack and stroke, such as

diabetes, high blood pressure and elevation of blood lipids (e.g.,

cholesterol, triglycerides).

Abramson, MD

Chairman of Rheumatology

NYU Hospital for Joint Diseases, New York

Having arthritis doesn't mean the end of a productive and satisfying

life. Patients should make every effort to stay physically active and to

engage in stimulating intellectual activities as well.

E. Sack, MD

Professor of Clinical Medicine, UCSF

Director of Clinical Rheumatology, Moffitt Hospital

University of California, San Francisco Medical Center

[Guest guest]

Mine is # 19! Go Northwestern!

[Editor's Note: Three of the top 20 are in NYC! YAY! Kathy F.]