What is a Rheumatologist?

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Rheumatologists are physicians trained to treat osteoporosis, rheumatoid arthritis, musculoskeletal and autoimmune diseases. To qualify, these medical professionals must complete four years of medical school, three years of residency training in pediatrics or internal medicine, and three years of specialized training in rheumatology. After completing training, rheumatologists have to pass a rigorous exam to become board certified by the American Board of Pediatrics or the American Board of Internal Medicine.

There are many types of rheumatic diseases. These diseases can be complex, and may be hard to diagnosis in the early stages. Rheumatic diseases tend to progress over time. Rheumatologists have the knowledge and experience to recognize symptoms early and establish an individualized treatment plan to best meet the patient's needs.

Talking to Your Rheumatologist: An Insider’s Guide to a Productive Doctor-Patient Relationship

Sitting in the reception area awaiting your first visit with a rheumatology specialist your heart beats a little faster than usual, your palms sweat some and your mind ponders a multitude of questions: Why did my doctor refer me here? Will this new doctor be able to diagnose me? What if I can’t tolerate the treatment he/she recommends? You may not get answers to all of these and other important questions right away, but one thing is certain—the more engaged you are as a patient the better the rheumatologic treatment you will receive. This is true whether you have been seeing your rheumatologist for 20+ years or whether you are awaiting your first visit. By being your own advocate, by preparing well for your rheumatology doctor visits, and by communicating openly and honestly, you can optimize the time spent in your doctor’s office and more importantly ensure you receive the best possible healthcare.

If you are someone awaiting that first rheumatology specialist visit, a few special guidelines apply:

  1. Bring along a support person (family member, neighbor, friend) as they can help you relax, remember important questions to ask, and/or help you remember details from your appointment.
  2. Bring along copies of test results or X-ray reports unless you have confirmed that the rheumatologist has already received these from your referring doctor. Often, referrals are made because of abnormal test results, but don’t assume these reports have made it to the specialist’s office.
  3. Be organized and prepared heading into your appointment. Jot down and be prepared to describe your two or three most concerning symptoms in detail. Where are they? When did they start? How long do they last? What aggravates and alleviates the symptoms? And don’t be afraid to share your own ideas regarding the cause of your symptoms. Good preparation also includes writing down your questions as it is easy to forget them in the midst of an appointment. Prioritize your questions, however, as time is usually limited and you don’t want to have your most important question go unanswered.
  4. If possible, research your symptoms prior to your appointment in order to know what your doctor may be looking for and so you know what questions to ask.
  5. At the end of your visit, be sure you leave knowing the doctor’s assessment, his/her recommendations, and why it is important for you to follow these recommendations (Sometimes referred to as the “Ask Three” approach). Nearly all of the time spent on your first visit will involve your doctor gathering information from you. The first two parts of your visit, the history and physical exam, are intended for your doctor to collect information regarding your problem. During the final part of your visit, the doctor should share his assessment and recommendations with you. Be sure to listen attentively at this point in your appointment. If his/her discussion does not address the big three questions, ask your doctor specifically for these answers.

For patients in an ongoing relationship with a rheumatologist, several of the recommendations above will also apply. It is still very important to prepare for appointments by writing down concerning symptoms and questions. Again, prioritize your concerns and questions since follow-up visits will be far briefer. Other aspects of the doctor-patient relationship will be different for established patients:

  1. Write down an interval summary of events since your last visit, especially if other doctors have rendered care or changed your treatment (e.g. your orthopedist injected your left shoulder 3 weeks earlier).
  2. Partner with your doctor. Most rheumatologists view their ongoing interactions with patients as a partnership. They want their patients to take part in decisions. The decision to start or switch therapies is one you and your rheumatologist should make together. Don’t hesitate to share your goals and preferences with your doctor. It is also important to discuss barriers to effective care, e.g. financial limitations or conflicts with one’s daily schedule.
  3. Be honest with your doctor even if that means sharing information about which he/she may disapprove. If you have not faithfully taken a prescribed medication and you neglect to mention this, he/she may increase your dose or add a new medication thinking this is necessary to control your disease. Or if you omit listing that new supplement your friend gave you it could lead to an undesirable drug interaction with one of your prescribed medicines.
  4. Lastly, don’t hesitate to make a follow-up phone call if you have a problem or question in between office visits. You should be able to get an answer to your problem even if you are not able to communicate directly with the doctor.

Whether you are awaiting a consultation with a rheumatologist for the first time or have been a patient for more time than you care to admit, following a few simple suggestions can make the experience better. By properly preparing for your appointments, writing down key concerns and questions, and communicating honestly you can work together with your doctor to ensure excellent rheumatologic care.

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