2015 Top Doctor: Paul Howard, MD

Category: Profiles Issue: April 2015
Group Mid-Level
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Rheumatology

Med School/Year Graduated: Georgetown University School of Medicine, 1979
Years in Practice: 31

What inspired you to pursue this career path?
I love the field of rheumatology. The intense search for the correct diagnoses, the use of tremendous advances in immunology to treat previously uncontrollable diseases, and the lasting relationships with heroic patients who show great courage and resilience attaining better health all blend into what I feel is the best career in medicine. Rheumatologists are specialists who oversee the global and holistic care of their patients.  
 
Does rheumatology encompass ailments outside of arthritic conditions and musculoskeletal health?
Rheumatology is also involved with systemic disease such as lupus, Sjögren’s [syndrome], scleroderma and vasculitis along with the prevention and treatment of osteoporosis, management of pain beyond medications, and the restoration of improved physical functioning when muscles or joints are damaged.

Is it true that cracking one’s knuckles can cause arthritis? What are some arthritis myths?
No, I am sorry to disappoint all the mothers and fathers in the world, cracking your knuckles does not lead to arthritis. But it is still annoying. There are many myths about arthritis. The most damaging is that there is nothing to do for arthritis. On the contrary, many arthritic conditions are controllable and some are even curable. Yes, we actually think in terms of stopping arthritis in its tracks for some conditions.   

You have tai chi and yoga instructors on your staff. How do these practices help your patients manage their arthritis or other rheumatic ailments?
Movement and exercise are key to good heath, especially if you have arthritis. They are sometimes more important than medications and drugs – so important, we consider them our fifth vital sign: blood pressure, pulse, height, weight and how many minutes of exercise per week. Exercise such as yoga and tai chi improve strength, balance and flexibility in a protected fashion. They help preserve and improve physical function. Oh, what is the proper dose of exercise? 210 minutes per week – that is 30 minutes every day.

“If I wasn’t a doctor,
 I’d be...”
A baker. I love the ongoing chemistry experiment between flour, yeast, time and creativity.