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A typical day

A clinic of 15 to 25 patients: swollen hands, back pain that will not quit, a rash plus fevers, gout flares. You examine every joint, read blood work and X-rays, adjust powerful immune-suppressing drugs, and inject a knee or shoulder on the spot. A few hospital consults for a patient with a mystery inflammation. Lots of forms for drug coverage, since biologics cost thousands a month. Home by 5 or 6 p.m.