An interview with Dr. Joan Von Feldt

Joan M. Von Feldt, MD

Associate Professor of Medicine
Department of Medicine, Rheumatology Division
University of Pennsylvania School of Medicine
Philadelphia , PA

In your opinion, why do patients with RA continue to progress to a stage of disability before a diagnosis is established and appropriate therapy is initiated?

In my opinion, the primary reason patients progress to disability in RA is poor access to specialists, especially in some of the more rural areas around the country.

For patient referrals in RA, where does the gap exist between PCPs and specialists? Why does the gap exist?

The PCP’s access to specialists is very restricted and limited. There are also too many referrals occurring for the treatment of chronic pain in these patients, which is an important problem. However, there are is only so much that can be done and not enough hours in a day to address the needs of patients seen in the primary care setting.

What can be done to identify and diagnose patients with RA sooner?

Educational efforts, directed toward patients and PCPs (such as those provided by the CME Lounge) would go a long way towards improving the identification of RA patients.

How will the role of primary care, in the identification and management of patients with RA, expand in the future?

I really see a move towards improved efforts to identify patients with RA earlier through the development and implementation of partnerships that manage disease and comorbid conditions.

Can organizations that provide CME improve their efforts to educate physicians? If so, how?

The continued use of multiple venues, including the use of the Web, and half-day or full-day CME programs, are important for continued progress to occur.

What other topics related to your practice would you like to see addressed in future educational activities?

Mixed programs that include diagnostics and management of comorbid conditions would be invaluable.