Strategies for Workforce Retention

In this episode, we discuss the growing workforce challenges in rheumatology with nurse practitioner Chris Estes. Chris shares how he entered the field, the training he received early in his career, and how he developed expertise in musculoskeletal ultrasound. The conversation explores how advanced practice providers (APPs) can help address rheumatology workforce shortages by expanding access to care—seeing new patients, managing follow-ups, and working both collaboratively and independently within a practice. Chris also discusses training pathways for new APPs, common misconceptions practices may have, and how investing in APP development may be an important strategy for the future of rheumatology care. 

In this episode, we explore the paradox of gout—one of the most biologically understood and treatable diseases in medicine, yet still among the most poorly controlled chronic conditions in practice. With effective therapies readily available, why do patients continue to cycle through painful flares, start and stop medications, and return to clinics and hospitals in a pattern that feels like a recurring failure? We unpack the complex interplay between biology, patient behavior, medication adherence, and health system barriers, asking whether the problem lies in the disease itself or in how care is delivered. As new treatments emerge, we also question whether innovation alone can solve the problem—or whether lasting change requires fixing the systems struggling to fully use the tools already at hand. 

In this episode, we explore Antiphospholipid Syndrome (APS) with Dr. Yu (Ray) Zuo, beginning with a clear, clinically grounded explanation before diving into the personal and scientific journey that drew him to this notoriously complex disease. Along the way, Dr. Zuo shares a case that forever changed how he understands APS, then takes us inside his latest Arthritis & Rheumatology study, where machine learning reveals hidden patterns that may reshape how we think about patients and risk. The conversation moves from bedside to bench and back again, tackling what AI can—and can't—do for rheumatology, where APS research is headed next, and what early investigators need to know to build impactful careers. 

In this episode, we sit down with Dr. William Harvey, the newly appointed President of the American College of Rheumatology and a dedicated volunteer of nearly 20 years. Dr. Harvey shares what it's like stepping into the presidency, the key priorities shaping the year ahead, and how the ACR is approaching strategy, advocacy, partnerships, and leadership during this pivotal moment for the field. 

In this episode, our expert guest challenges a common assumption by explaining why the T-score—despite being central to osteoporosis diagnosis—is surprisingly easy to misinterpret. He walks us through how to read a DEXA scan like a detective, highlighting subtle clues that can dramatically improve diagnostic accuracy for your patients. Once osteoporosis is identified, the conversation turns to clinical decision-making: how to choose between anabolic agents, denosumab, and bisphosphonates, and why that choice depends on thoughtful risk stratification and patient-specific comorbidities. We also dive into the often-overlooked importance of sequencing osteoporosis medications correctly, including a compelling discussion on why starting with an anabolic agent may offer greater long-term benefits than reserving it as a last-line option. 

In this episode, we explore malignant atrophic papulosis—also known as Degos disease—an extraordinarily rare microvascular disorder so uncommon that most clinicians will never see a single case. For decades, medical literature labeled it "uniformly fatal." Our guest, Dr. Lee Shapiro, encountered this reality when he began treating a rapidly deteriorating 16-year-old boy with no clear treatment path. Driven by urgency, he reached out to experts across the country, slowly piecing together clues that ultimately led to the first successful treatment of systemic Degos disease. Today, Dr. Shapiro is a leading advocate for patients, connecting a global community, promoting early recognition, and working tirelessly to expand access to life-saving therapies.    Learn more at The Degos Disease Foundation 

Once the prescription is written, pharmacists like Katherine McCarthy step in—often becoming the steady guide patients rely on throughout their health journey. Specializing in the care of people with rheumatic diseases, Katherine tackles insurance barriers, supports patients through biosimilar transitions, and helps demystify complex medication regimens. Her work underscores just how pivotal pharmacists are in driving better outcomes in rheumatology. 

This episode explores the evolving intersection of rheumatology and cognitive science, beginning with what initially drew researchers to investigate cognitive symptoms in patients with rheumatoid arthritis (RA). We discuss the prevalence and nature of patient-reported cognitive concerns, how these subjective complaints compare with objective neurocognitive testing, and what current studies reveal underlying inflammatory and neurobiological mechanisms. The conversation examines the cognitive effects of commonly used RA therapies, as well as modifiable contributors—including physical activity, sleep apnea, diet, and stress—that clinicians should assess in routine practice. We also consider when formal neuropsychological evaluation is warranted, how to counsel patients seeking to prevent cognitive decline, and the most pressing unanswered questions that remain in the field. 

In this episode, we explore what happens when clinicians look beyond the prescription pad and begin listening more deeply to what their patients have lost. This isn't a conversation about rejecting medications but about expanding the tools we use to foster healing. We discuss the concept of disenfranchised grief—the often-unspoken losses that accompany chronic illness—the intricate links between depression and inflammation, and the transformative power of helping patients heal in ways that no pill alone can achieve.  This episode was sponsored by Pfizer

In this episode, we shine a light on Calcium Pyrophosphate Deposition Disease (CPPD)—a condition that has been hiding in plain sight for decades. Despite being common, painful, and prevalent in clinics everywhere, CPPD has long been misdiagnosed, undertreated, and under-researched. Our guest has been working to change that by uncovering the genetic and molecular underpinnings of the disease and exploring new ways to improve patient outcomes. We discuss what's new and what's next for CPPD, why it may be the most common inflammatory arthritis after age 60, how it overlaps with rheumatoid arthritis and osteoarthritis, and what emerging studies of biologics are revealing about its biology and untapped therapeutic potential.  This episode was sponsored by Pfizer