Hamilton Herald Masthead

Editorial


Front Page - Friday, March 26, 2010

Rock-n-Roll rheumatologist offers sweet music for patients




Music lover, Dr. Richard Brackett, stands in front of part of his record collection in his Shallowford office. Brackett says the best act at Bonnaroo last year was Elvis Costello. - Erica Tuggle
Rheumatologist Richard Brackett is one rockin’ doc. Framed records of the late George Harrison brooding on a park bench, the Beatles strutting their stuff on Abbey Road, Bob Dylan’s serious mug and Bruce Spring-steen hiding a smile on the cover of “Born to Run” are the first things to catch your eye when you enter his Shallowford Road office.
Dr. Brackett speaks with laid-back candor of how the shirt Jimmy Buffet is wearing on the album “Volcano” is Brackett’s shirt, thrown at the musician at a pool party they were both at.
“I wrote a letter to him, telling him the story of how my shirt ended up in his possession, and they told me to send in my album so that he could sign it,” Brackett says.
He also says in the same nonchalant manner that Bonaroo was fun last year.
“Elvis Costello, hands down, was my favorite act,” he says. “Springsteen and Phish were good, but Elvis Costello was off the chart.”
Although music is a passion for Brackett, his dedication goes out to his patients.
“The patients are pretty amazing people, adapting to chronic pain and disabilities they suffer through,” he says. “They’ve got a good spirit and a good heart.”
Although, his father was a physician, Brackett says he never thought he’d want to go into medicine. But once he got the bug in college, the idea caught on and made sense to him. He went through training at the University of Tennessee and then internal medicine training at Erlanger, before returning to Memphis to earn his specialty in rheumatology. He began in group practice at Memorial for 15 years, and then opened up his own practice on Shallowford five years ago.
He said most of the patients he sees have already talked to their primary care physician, who has identified their pain symptoms as belonging to either the regular “wear and tear” type of arthritis (osteoarthritis) or one of the kinds that are more modulated by the immune system, and thus require further diagnostic studies or advanced treatment.
Rheumatoid arthritis usually affects the small joints in the hands and feet by causing them to swell and become inflamed, Brackett says. It is the damaging form of arthritis that can result in deformities. Patients may have infrequent stiffness in the morning that can last an hour or more.
“Fortunately, we have some good treatments that can slow or remit some of this type of arthritis,” he says.
With the “wear and tear” arthritis, good prevention methods such as staying near your ideal body weight, regular exercise and stretching exercises can help reduce the symptoms of osteoarthritis that bears down on joints such as the knees, he says.
“There is a lot of folklore and remedies out there, and a lot of money is spent on these sort of things,” he says. “But really none of these has been shown clinically to be efficacious.”
Brackett says a misconception with arthritis is that there is nothing that can be done about it, when this is “nothing further from the truth.”
“There is a lot to be done to alter the course of arthritis; to give comfort and relief and help out with other situations like rehab and disability issues,” he says. “We have a lot to offer.”
Another medical industry myth, according to Dr. Brackett, is that doctors are in charge of healthcare.
“There are so many other players involved. We would love to have more control of the process,” he says. “99.9 percent of us would want to do it in a way to help patients first. A happy patient is worth all the riches in the world to us, and I think that’s true for the majority of doctors.”
While the interaction he has with patients and his staff is the best part of his job, he says, the worst part is the bureaucracy in dealing with what is approved and not in the changing landscape of medicine.
He says, “None of us particularly like being businessmen.”
In particular, the changes in insurance will directly affect his business, he says, in limiting the programs his patients can sign up for.
“We are having to restrict the number of Medicare patients we see, and, more importantly, there is a high number of our patients that were not insured that can’t come see us now without insurance.”
Brackett says 50 million people in the US have arthritis and that it is the number one cause of disability.
“Arthritis is not just joint pain, but rather, these are systemic diseases that have life threatening consequences; so, it is a huge issue. It is underserved. There are not that many people that want to go into rheumatology,” he says.
The reason why the number of those going into rheumatology is down, he says, is the long course for training and the emotionally challenging task of caring for people in chronic pain.
“It is not like dealing with someone who is having their first baby,” he says. “We are not a procedure oriented specialty, so young doctors perceive this as poorly compensated for the amount of work we do.”
Brackett says he enjoys raising his family and living downtown with his wife, Julie, who is an RN and works part-time in his office. They have a 19-year-old daughter, Natalie, a freshman at Washington University in St. Louis, and 16-year-old daughter, Chloe, who is at Baylor and loves sports.
He also enjoys open water swimming and having a burger at the Tremont Tavern, “the best chicken in town” at the Bud House or soul food catering by Moss.
Brackett says he plans to find a partner in the next five to ten years to pass his business along to.
“There are not many rheumatologists out there, so physician assistants and nurse practitioners will be helping more and more in the future,” he says. “I have a real good one who does a good job, and understands not only diseases, but the people that have them.”
At Brackett Rheumatology his attitude is to provide,
“competent and compassionate service beyond expectation,” he says. “We want an open door policy, and want to be available, we don’t want to be too big and we don’t want people to feel rushed. A kind word and a smile to someone in pain go a long way.”