A conversation I have almost every day

One of the first questions patients ask after hearing a diagnosis is surprisingly simple.

"Doctor… what's the best treatment?"

It is an entirely reasonable question. After all, when someone finally has a name for what they have been living with — rheumatoid arthritis, lupus, gout, osteoporosis — the natural next step is to ask how to make it better.

But before I recommend any medication, I ask myself a different question:

"What treatment gives this particular patient the greatest chance of getting well with the least possible burden?"

That single question has guided my practice throughout my career.

The best treatment is not always the newest

Every year, new medications reach the market — and many of them are genuinely remarkable. Biologics and targeted therapies have transformed how we manage rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and lupus.

But newer does not automatically mean better for every patient. A newly approved drug may be more expensive, less familiar in real-world use, and sometimes not clearly superior to well-established options. The decision should always be based on evidence, experience, and the individual sitting in front of me — not on marketing or novelty.

Every patient is different

Two people can walk into my clinic with the same diagnosis and leave with entirely different treatment plans. That is not inconsistency — it is good medicine.

What I consider before recommending a treatment:

How active is the disease? A young patient with early, aggressive rheumatoid arthritis needs a very different plan from someone with mild, long-standing disease.
Other medical conditions. Kidney function, liver disease, heart disease, previous cancer, or infections all shape which medications are safe.
Age and life stage. A woman planning a pregnancy needs medications compatible with conception and breastfeeding. An older patient may need extra caution around infection risk and bone health.
Lifestyle and work. Frequent travel, shift work, or a physically demanding job can influence which regimens are practical.
Previous responses. What has worked — or failed — before is one of the most useful pieces of information I have.
Patient preference. Some patients strongly prefer tablets over injections; others prefer the opposite. Both are valid.

Starting simple when it makes sense

In many cases, the right first step is a well-established medication that has decades of evidence behind it — methotrexate for rheumatoid arthritis, colchicine and allopurinol for gout, hydroxychloroquine for lupus, bisphosphonates for osteoporosis.

These are not "old-fashioned" choices. They are proven, affordable, and often achieve outstanding results. When they are not enough, we escalate — thoughtfully, and with a clear plan.

Cost is part of the conversation — but never the whole conversation

I never let cost dictate care when a specific treatment is genuinely needed. But when two treatments offer similar effectiveness and safety, it is only fair to discuss the practical side — including what a patient's insurance covers and what they would pay out of pocket.

In Dubai, we are fortunate that most major insurers cover a wide range of rheumatology medications, including many biologics. Understanding your coverage is part of a realistic treatment plan.

Shared decisions lead to better care

Every patient deserves an explanation — not simply a prescription. I try to make sure that by the end of a consultation, my patient understands:

What the diagnosis is, in plain language.
Why I am recommending a particular treatment.
What alternatives exist, and why I have not recommended them first.
What to expect in the coming weeks and months.
What side effects to watch for, and when to call.

A patient who understands their treatment is far more likely to take it correctly, stay on it long enough for it to work, and tell me honestly when something is not going well.

A final thought

When patients ask me, "Doctor, what would you do if I were your brother, your sister, or your parent?" — I understand what they are really asking. They want advice that is honest, thoughtful, and free from unnecessary complexity.

That is the standard I try to hold myself to with every patient: recommend the treatment that offers the greatest benefit, the least unnecessary burden, and the best opportunity for long-term health.

If you would like to discuss your own diagnosis or treatment, you are welcome to book a rheumatology consultation at Health Call Clinic in Dubai Healthcare City.