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Rapid response to:

Views & Reviews From the Frontline

Bad medicine: rheumatoid arthritis

BMJ 2011; 343 doi: (Published 05 October 2011) Cite this as: BMJ 2011;343:d6357

Rapid Response:

Re:Bad medicine: time to look in the mirror, perhaps?

While I would disagree with Dr Spence on a number of points, nobody
really uses American College of Rheumatology criteria or validated
questoionaires to make a diagnosis of rheumatoid arthritis. I would agree
with the general thrust of his argument, rheumatoid arthritis is getting
milder and less common, there is a push to over diagnose and over treat,
driven by NICE etc and as rheumatologists we frequently can't distinguish
RA from fibromyalgia.
Dr Spence's views will not endear him to the rheumatology establishment
but I do commend him for expressing them.

Competing interests: No competing interests

12 October 2011
Philip N Platt
Consultant Rheumatologist
Freeman Hospital