Transforming Outcomes with Early Intervention: ARCK’s Blend of Quality and Compassionate Care Improves Quality of Life for Rheumatology Patients

By Sarah Gooding
Tuesday, December 20, 2016

Compassionate, ongoing relationships between patients and caring physicians, as well as prompt referrals and advances in technology, have transformed the field of rheumatology in the 22 years Timothy Shaver, MD, FACP, has been in practice.

The team at ARCK (L-R): Maya Estephan, MD; Stacy Wagner, PA-C; Timothy Shaver, MD; Shirley Wang, MD; Shadi Shahouri, MD; Ruth Busch, APRN; and Melanie Rohr, MD

The changes are clear in his waiting room, which once was filled with patients in wheelchairs exhibiting severe symptoms related to the progression of their rheumatoid conditions.

Today, it’s a different story.

“I’ve seen a trend toward people getting referred much earlier, and that’s kudos in part to the primary care physician population,” Dr. Shaver says. “I think they’re identifying these patients earlier and referring them earlier.”

Dr. Shaver says this makes all the difference in patients’ long-term outcomes.

“It’s been proven that, if you have new-onset rheumatoid arthritis, the intervention of seeing a rheumatologist within the first six to 12 months results in a lower rate of surgery and a higher level of function in that patient,” he says.

Advantages of referrals

“Everybody I see in my office as a new patient I put in one of two categories,” Dr. Shaver says. “They may have something that we simply treat the symptoms, and we may be able to reduce the symptoms and help them feel better.

“There are other conditions which, if we don’t treat them, have the ability to progress and develop complications, and if we can intervene early enough, we can prevent those complications.”

Dr. Shaver says he has three basic goals that apply regardless of category: address and minimize symptoms, prevent damage, and optimize function.

From there, ARCK physicians determine how best to carry out a treatment plan.


ARCK’s Shirley Wang, MD, with Shadi Shahouri, MD (left), and Timothy Shaver, MD, explaining benefits of infusion therapy to a patient.

“We will always communicate back to the primary care physician,” Dr. Shaver says. “If there are recommendations I can give to that physician and feel confident they will take the ball and run with it, then I will give them the suggestions on how to do that. But, if it’s something that requires a more focused effort from a specialist and that’s going to make a difference in how this patient does down the road, then we will stay involved.”

Quality care and quality of life

That involvement is crucial for patients with conditions such as rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis and autoimmune disorders, because of the complexity involved in managing a chronic condition.


Dr. Shahouri, Dr. Wang and Dr. Shaver reviewing advanced features of new ultrasound technology

“We have the time, the expertise and the tools to really focus on the patients’ rheumatic disease, so we can fine-tune the treatment and appropriately monitor the complications, and that can really take the burden away from primary care physicians,” Dr. Shaver says.

Rheumatoid conditions also interact with other bodily systems, increasing risk for cardiovascular disease, diabetes and osteoporosis.

“The No. 1 thing people think of is joint damage and the deformity and disability that can occur, but we’re also starting to appreciate the huge cardiovascular risk when it comes to rheumatoid arthritis,” Dr. Shaver says. “Patients who have rheumatoid arthritis have roughly double the risk of cardiovascular disease as age-match controls and roughly double the mortality of age-match controls.”

He says this risk, similar to that of a diabetic, has more to do with the inflammatory burden of rheumatoid disease than traditional risk factors, but the use of the right therapies to control the disease can reduce mortality rates significantly.

Other conditions, such as osteoarthritis, can be aggravated by both the disease and its treatments.


The Arthritis and Rheumatology Clinics of Kansas expanded this year, with Shirley Wang, MD, heading up the opening of a second location at 801 N. Mur-Len, Suite 112, in Olathe. The new clinic is positioned to meet a need in the Kansas City metropolitan area.

To monitor and minimize the inflammation and impact, ARCK’s Wichita clinic is well-equipped with digital radiography, ultrasound, extremity MRI and a bone densitometry machine.

“What’s driven a lot of these technologies is the availability of biologic therapies,” Dr. Shaver says. “Because the biologic therapies are more costly and also potentially more effective, we need some tools to help in our decision-making process. This can help strategize the aggressiveness of our treatment plan.”

Dr. Shaver cites MRI, which can help predict whether continuation of a treatment will result in further damage. While MRI is more expensive than ultrasound, it can provide an in-depth look at the bony structures involved and costs a fraction of the monthly cost of some therapies.

Dr. Shaver says the intense focus on quality care can pay tremendous dividends for patients’ quality of life.

“We want to make sure we’re optimizing their ability to function, their ability to work, their ability to provide for their families and their ability to do the things they enjoy doing,” he says.

Practice growth

ARCK also has made a name for itself among both patients — who come from all over Kansas, northern Oklahoma and western Missouri — and providers, many of whom spend time at the clinic for their rheumatology rotations.


From left, Stacy Wagner, PA-C; Maya Estephan, MD; Timothy Shaver, MD; Shirley Wang, MD; Shadi Shahouri, MD; Melanie Rohr, MD; and Ruth Busch, APRN

Shadi Shahouri, MD, FACP, and Shirley Wang, MD, FACR, both are known for their compassionate practice and the role they play in further educating the medical community. One of ARCK’s newest physicians, Maya Estephan, MD, was a resident at ARCK.

Dr. Shaver says this is a compliment to the practice.

“I feel positive about the people who have trained here wanting to return here,” he says. “I really believe the reason this has happened is they see how invested we are in treating our patients who have these illnesses and doing so in a quality-conscious and cost-conscious fashion.”

Another new physician at ARCK, Melanie Rohr, MD, wanted to be near her family, so she returned home to Wichita after her training.

ARCK also expanded this year and added a second clinic, under the direction of Dr. Wang, in the Kansas City suburb of Olathe.

About Timothy Shaver, MD


Timothy Shaver, MD

When Timothy Shaver, MD, FACP, was considering specialties, the field of rheumatology was very different than it is now.

“I never would have guessed that was what I was going to specialize in,” says Dr. Shaver, who co-founded the Arthritis and Rheumatology Clinics of Kansas in 2001.

“When I first heard there was a specialty in rheumatology, I thought, ‘Why would that exist?’ It seemed very narrow, but as I went further in my training I got an idea of the broader scope of what a rheumatologist did and I started noticing that whenever I saw a patient with rheumatic disease, that would be the most interesting patient I would serve.”

Dr. Shaver, who says he models his career after Jesus Christ, the Great Physician, says the opportunities to practice with compassion, devotion and excellence drew him to the field.

He attended the University of Kansas Medical School in Kansas City and Wichita and then continued his education with residency and subspecialty fellowship training at the University of Oklahoma.

While in school, he met and married his wife, Kay. The two have been married for 29 years and have a 27-year-old son, Dawson, who is a fourth-year medical school student, and a 23-year-old daughter, Drea, who is finishing nursing school.

In the 22 years Dr. Shaver has practiced medicine, his chosen field has seen significant advances.

“When I made a decision to pursue that specialty, the treatments were decent, but they were not nearly as great as they’ve become,” Dr. Shaver says. “I’ve seen the field advance, and it has gone from a specialty where we’ve got some knowledge and some expertise and we really care to — we’ve got some great knowledge and some great tools, and we really care. It’s nice to see that it’s come along that far.”

About Shadi Shahouri, MD


Shadi Shahouri, MD

Shadi Shahouri, MD, FACP, brings top-notch medical care and a passion for clinical research and education to his partnership role at ARCK.

Dr. Shahouri received his medical degree from the American University of Beirut in Lebanon. He made his home in Kansas after completing one year of family practice and a three-year internal medicine residency at the University of Kansas in Wichita, followed by a fellowship in rheumatology at the University of Kansas in Kansas City.

Dr. Shahouri’s mission at ARCK is to provide cutting-edge medical care for patients with different rheumatic conditions, perform state-of-the-art diagnostic and interventional musculoskeletal ultrasound procedures, participate in research to advance understanding of rheumatic diseases, and prepare future Kansas physicians as a volunteer faculty at his alma mater in Wichita.

About Shirley Wang, MD


Shirley Wang, MD

Shirley Wang, MD, FACR, has been a leader through her partnership role at Wichita’s ARCK campus and in expanding the clinic to its second location in the Kansas City metro.

Dr. Wang completed her medical education at the University of Kansas with subsequent internal medicine training at KU-Wichita and a rheumatology fellowship at the University of Oklahoma.

She was honored on the 2015–16 list of Best Doctors in America and is a member of many leading physician groups in the field of rheumatology.

Dr. Wang’s key interests include early detection and timely treatment of joint and rheumatic diseases, scleroderma, rheumatic diseases and pregnancy, and pediatric rheumatic diseases.

For more information about ARCK’s mission, physicians or clinics, please visit arck.org or call 316-612-4815.