An interview with Philip Mease, MD

Philip Mease, MD
Chief of Rheumatology Research
Swedish Medical Center
Clinical Professor of Medicine
University of Washington
Seattle, WA

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?

Lack of recognition of the disease diagnosis and lack of understanding of the importance of timely diagnosis and treatment are the primary reasons RA patients progress to disability.

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

There is a lack of understanding by PCPs of the potential gravity, in terms of downwind disability and CV disease, associated with RA. Therefore there is a need for prompt referral. The gap exists because there is a sense that “I can handle this myself”.

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

Educational efforts directed towards PCPs that focus on the gravity of an RA diagnosis.

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

I think there will be increased recognition that the consequences of lack of proper identification and management leads to early disability and mortality, and thus the importance of early identification and referral to construct program of proper management will be emphasized.

What are some of the ways primary care can integrate with other disciplines in a multidisciplinary approach to therapy across the continuum of therapeutic areas?

Electronic medical record systems, or EMRs, and increased communications via the phone will contribute greatly to integration between disciplines.

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

I really believe that these organizations can help to identify optimal ways to gain the attention of overstimulated PCPs whose time is already limited. It is up to these organizations to identify and implement new strategies that utilize the available technology.

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

Management of central pain in rheumatic diseases, aka “fibromyalgianess”, in patients with RA, and the occurrence, diagnosis and treatment of lupus. The same can be said for osteoarthritis…

Suggestion: Does it make sense to do a whole program on Managing Comorbid Conditions in RA?

Yes. This area is quickly becoming more important as a means of improving morbidity and mortality in RA