Views & Reviews From the Frontline

Bad medicine: rheumatoid arthritis

BMJ 2011; 343 doi: (Published 05 October 2011) Cite this as: BMJ 2011;343:d6357
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}

Inflaming the establishment is a civic duty, for medicine is a force not only for good but also for harm. The young learn to value experience only once they have gained it. In my experience there has been a dramatic decline in the severity of rheumatoid arthritis. Once common clinical signs such as ulna deviation are now rare, even on medical wards. Evidence supports my experience, with a halving of rheumatoid arthritis rates from 1955,1 and major declines in the rate of orthopaedic interventions.2 3 This reflects a change in the epidemiology and improvements in medical care. …

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