Rheum Consult

The Rheumatology consult service at LAG-USC Medical Center consists of a team of an attending physician, a fellow, 1-6 interns and/or senior residents, and sometimes a medical student. Consults are accepted at any time from medicine teams, non-medicine teams, and the ED.

Educational Goals & Overview

LAG Rheumatology Consult Orientation
LAG Rheumatology Consult Orientation
USC/LA General Rheumatology Division Website
USC/LA General Rheumatology Division Website
Goals and Objectives
Goals and Objectives
Resources
Resources

  • Request sign-out from the outgoing resident the day prior to starting your rotation. Contact the LAG Rheum Consult Fellow listed on Amion to coordinate where and when to meet the Consult team members.

  • Attending rounds will typically occur from ~10:00 AM-12:00 PM on Mondays, and from ~1:00-5:00 PM all other weekdays. Faculty are expected to perform bedside teaching, discuss pathophysiology, and use current literature to aid in diagnostic and therapeutic decisions. The attending on service is listed on Amion.

    • Consults are sent to the LAG On-Call Fellow personal pager based on the Amion schedule. The Teams messaging app and service consult line (323-409-4338) should be avoided, as they may contribute to delays in care.

    • Residents on service legally CANNOT accept/deny consults – if you are contacted by a consulting provider, please direct them to the Fellow On-Call.

    • The Fellow On-Call will distribute patients to trainees on service.

    • Rheum clinic occurs every Monday at 1pm and Tuesday at 8am in OPD 5P1 (Multispecialty Clinic). We also provide care to incarcerated patients through the jail clinic in 1E on Wednesdays at 9am.

    • Clinical Conference takes place every Monday at 8am on Zoom. You may be asked to present a case you have seen while on service. There will also be a dedicated resident lecture every Wednesday at 9am on Zoom. We have regular pulm/rheum and rheum/renal conferences on Zoom, you will be notified if they are scheduled during your time on service. The fellow on-call will share all links with you.

  • Rheumatologic diseases are systemic illnesses that can affect virtually every organ, requiring a detailed and systematic approach to the patient evaluation.

    • ROS must include mucocutaneous, musculoskeletal, genitourinary, neuro-ophthalmologic, and cardiopulmonary systems.

    • Physical exam should include skin, mucus membranes, joints, heart, lungs, and strength.

    • A detailed social and family history can help assess for potential mimics of rheumatologic diseases.

    • Obstetric history is necessary for all female patients.

    • For patients with a known history of rheumatologic disease, please note their disease manifestations, serologic pattern, and treatment history, and provide this as a succinct “disease statement” (e.g. SLE characterized by class IV nephritis, inflammatory arthritis, and malar rash; ANA+, dsDNA+, Sm-, hypocomplementemia; previously treated with steroids and CYC, now on HCQ and MMF).

  • Team members are expected to communicate all recommendations to the primary teams after rounds, by end of day via Voip or Teams.

Rheumatology Clinic

The Rheumatology Diseases clinic occurs on Monday at 1pm and Tuesday at 8am in OPD 5P1 (Multispecialty Clinic). We also provide care to incarcerated patients through the jail clinic in 1E on Wednesdays at 9am.

If you are on consults and in Rheum clinic, please complete clinic and return to the hospital to evaluate consults in the morning or afternoon depending on your clinic schedule.