Humaira H. Khan
On the ninth floor of the Arnold T. Berman, MD, Building, which houses the offices of Drexel University Medicine’s Rheumatology Division, is a small, nondescript room that acts as the facility’s four-chair infusion center.
Despite its unassuming nature, the room is unique for Philadelphia in that it is the only office-based — rather than hospital-based — infusion center in the city. According to Humaira H. Khan, MD, medical director of the infusion center in the division of rheumatology at the Drexel University College of Medicine, that seemingly small distinction has meant a tremendous difference for insurance providers, who have begun sending them patients from all over Philadelphia metro area.
“We also have an infusion center across the street at Hahnemann University Hospital, which is an outpatient center,” Khan told Healio Rheumatology. “However, it is a hospital-based infusion center, so most insurance policies don’t allow it. It depends on the patient’s insurance, but most insurance companies don’t want their patients to go to a hospital setting, because the payment is much more than they would pay for an office setting.”
According to Khan, the office-based infusion center at the Arnold T. Berman, MD, Building began 18 years ago, and was initially only used by patients at Drexel Medicine. However, today, insurance companies routinely send 35 to 40 patients from throughout the city through its doors each week; there are plans to expand the infusion center, from four beds to eight, and to add another nurse, to accommodate the increasing volume.
“It used to be exclusively our patients, but now we are getting them from everywhere,” Khan said. “Also, it’s not only rheumatology patients — we have dermatology and gastrointestinal patients coming in as well.”
Drexel Medicine’s rheumatology division is also unique in Philadelphia for being relatively small, with just three full-time faculty members, along with two others who are semi-retired and see patients on a limited basis. However, according to Arundathi Jayatilleke, MD, an associate professor and one of the three full-time faculty in the rheumatology division, they are also dedicated to training new rheumatologists.
The division trains its own rheumatology fellows, of which there are four — two in their first years and two in their second year. These fellows help carry the patient load at the division, which sees about 200 to 300 patients come through its outpatient facility and infusion center every month.
According to Jayatilleke, with a rheumatologist shortage looming over the specialty, it is important for facilities of all sizes to focus on training.
“I think it is very important as physicians and educators that we train the next generation,” she told Healio Rheumatology. “That is important not just to our institution but to all rheumatology institutions, as well as all rheumatology divisions in this city. On the education side, we collaborate with other institutions in training our fellows, so we try to share our resources.”
“It is a very important problem, because there is a projected serious shortage of physicians within the next 5 to 10 years,” she added. “I think there is a large amount of room to expand, but unfortunately, because of the structure of medical training in the country, there is a limit on the number of training spots that are available, and without the appropriate funding for rheumatology fellows, places aren’t able to expand.” – by Jason Laday