Skip to content
Home » Your Relationship with the Rheumatologist

Your Relationship with the Rheumatologist

  • by
rheumatologist talks with patient

Patients often complain about their rheumatologists, and they describe numerous reasons why.  Some don’t like the way a doctor short-changes them on time during appointments. I had a rheumatologist like that when we first moved to Florida.  He breezed in, would look at my hands and then my ankles and pronounce me doing well on my biologic drug and then look at his watch.  I asked him once if I was making him late for something.  I kid you not, he smiled and said, “A tee time, but I’ll make it if I hurry.”

Another complaint I’ve heard is how difficult it is to get an appointment within a reasonable amount of time.  They talk of having to wait 6 months to a year for a new appointment and not much less for re-checks. If there is a shortage of this specialty where you live, I don’t know what you can do to improve this situation.

I read about a patient who wasn’t told anything about her lab results – just that there were no changes.  Changes from what?  She had no clue.

What Undiagnosed Patients Can Expect from a New Rheumatologist

A new patient should expect a longer appointment allotment.  That first visit should include a physical exam, a consultation including your history of symptoms and any diagnoses related to your visit.  The doctor should give you lab orders for a blood draw that will be tested for several things, and unless you had recent X-rays for the joints that concern him, he will schedule new X-rays. Other forms of imaging tests might also be included.

He might prescribe a medication for you while he awaits your test results or if you were already taking a medication prescribed by your former doctor, he may continue that drug until he gets the test results.

Most likely, your second visit with the rheumatologist will include setting up a treatment plan that best fits your needs as well as fitting what your health insurance will allow.

Your doctor should treat you and your symptoms with respect. You deserve to be heard. If he or she shows a lack of interest in your issues or in solving them, that’s a huge red flag!

What Established RA Patients Should Expect from a New Rheumatologist

Over the last 43 years since I was first diagnosed, I’ve seen several rheumatologists. That was due to moving to a new location or because said doctor did not live up to what I considered minimum standards of treatment. With several of those doctors, some agreed I had RA, even though I tested seronegative. But one insisted I take yet another anti-inflammatory drug that I had previously found didn’t work. He assured me I just didn’t give it long enough. Nope, after 9 months on it, I wasn’t going that route again.

The doctor should work with a new patient to find a treatment that works for both of you. If you have dealt with RA for a few years, your experience counts and should be listened to by the rheumatologist. But you as a patient must be open to new options from your doctor. Mutual respect is important. If you and the rheumatologist cannot find a common ground regarding your treatment, it may be time to move on.

If you have already found a medication that works for your symptoms, the new physician should be willing to continue it. If not, listen to his or her reasons and decide if that works for you. If not, this doctor may not be a good fit for you.

Luckily for me, since I began Enbrel 23 years ago, subsequent rheumatologists never objected and always wrote the proper prescriptions for me. I found that each new doctor required 3 or 4 visits per year, including lab work, but that eventually became 2-3 visits a year with lab work once he got to know me. Should you require changes in medication, more visits will likely be required.

Why a Good Rheumatologist Is Important for Your Treatment

Your rheumatologist is your most important ally in your RA battle.  You must maintain a good relationship with him or her for that person could be your doctor for many years to come. This man or woman is really the only person who will understand the severity of your disease and the struggles you deal with on a daily basis.

His or her understanding of your lifestyle is critical to your health. That doctor is the only one who can help with a spouse or family who don’t accept your current limitations or pain levels. Many RA patients I’ve spoken to feel emotionally broken because husbands refuses to believe the pain is so severe. They find themselves on the brink of divorce. A good doctor may be able to explain the disease to a spouse in a way that he wouldn’t accept from his wife. That may or may not help the marriage, but it might make your life easier.

What about the Doctor’s Front Office Staff?

A certain level of professionalism is expected. Friendliness is welcome. Good manners are a necessity! This works both ways. Treat the front office staff as you would want to be treated. If you encounter rudeness, speak to your doctor about it.

At one time, I was so put off by the rude receptionist at my rheumatologist’s front desk that I almost left the practice. I spoke to the doctor about it but I could tell he wasn’t going to address it. It was a large medical practice with a practice manager so I contacted that person, wrote a nice letter, giving him the name of the rude staff member and described the experience. I have no idea if my letter helped or not but over the last couple of years, the front office behavior has improved considerably. Be that squeaky wheel if necessary. Just make sure you have an alternative if you see no results.

The other side of this equation is that you should be super nice to the doctor’s staff. These people are your first contacts in the office and you will often speak to them when you call. Be nice to them and they will usually be nice to you!

Ask Questions & Take Notes

Take a list with you of any questions you have for the doctor. It’s easy to forget one if it isn’t written down. Make notes of specific times your joints hurt worse than other times. You doctor needs to know if certain medications cause you problems. For example, because of so many years taking NSAIDS to treat my RA, my esophagus took a nasty hit and I ended up with Barrett’s Esophagus. I avoid any kind of anti-inflammatory medication now. A rheumatologist once insisted I try Sulfasalazine. I refused because it was just another NSAID, and I knew it would cause a problem. Said doctor was angry and I got up and left his office.

I always keep a notepad of some sort with me in case my rheumatologist discusses something unfamiliar or uses an unknown medical term.

Decide Before You Go

Know what you want from the visit with your rheumatologist and be prepared. Remember to take your notepad and questions with you and any other information your doctor might need. Greet the front office staff with a smile and have the required documents handy. They will probably want to see your insurance card and driver’s license. We usually get back what we put into any project and visiting your doctor is no different. Treat your doctor and staff as you want to be treated and hopefully you will build a great relationship with all.

Leave a Reply

Your email address will not be published. Required fields are marked *