Guest edited by Drs. Daniel J. Wallace and R. Swamy Venuturupalli, this issue of Rheumatic Disease Clinics will cover several key areas of interest related to Best Practices and Challenges to the Practice of Rheumatology. This issue is one of four selected each year by our series Consulting Editor, Dr. Michael Weisman of Cedars-Sinai. Articles in this issue include, but are not limited to: The Economics of Rheumatology Practice in the United States, Manpower trends in rheumatology, Challenges to practicing rheumatology in an academic center, Challenges in practicing rheumatology in a government setting, Challenges to practicing rheumatology in a small private practice setting, Challenges to working in a large multispecialty organization, Challenges to practicing pediatric rheumatology, Clinical trials in rheumatology, Challenges in having an infusion center, Implementing treatment to target in the clinic, Future directions: implementing new technologies in clinical practice, Possible Challenges in Optimizing Medical Education for Rheumatologists, and the challenges of approaching and managing gout.