How to Choose a Rheumatologist
When you have pain in your joints or bones that your primary care doctor has been unable to ease, you may want to consider consulting a rheumatologist.
What do rheumatologists do, and why would you need one? Rheumatologists are specialists who treat arthritis, including?osteoarthritis?and?rheumatoid arthritis, and can also help you deal with tendonitis, osteoporosis, bursitis, and inflammatory back pain. In addition, rheumatologists treat?diseases such as lupus,?Sjogren’s syndrome, myositis, and scleroderma, plus pain syndromes like?fibromyalgia.?
Related: Rheumatoid Arthritis Diagnosis
Who Is the Right Rheumatologist for You?
So how do you choose the right doctor for you? And how do you know when the time is right for you to see one? “That’s a difficult question,” says?James Udell, MD, a rheumatologist with the Arthritis Group of Philadelphia and Bucks County in Pennsylvania. “It’s easier to know with some other specialties. For example, if you can’t breathe,?you?see a lung doctor, and if you’re having loose stools, you see a gastroenterologist,” he notes.
But the symptoms people have when they need to see a rheumatologist are often vague. “It’s not uncommon for us to see a patient after he or she has seen multiple other doctors,” he says.
As soon as you suspect you have a bone or joint problem, check in with a rheumatologist, suggests Dr. Udell. “The earlier we see a patient, the better they will do in the long run.”
These answers from Udell and people living with RA to questions about selecting the right rheumatologist will help you find the best specialist for you:
What Did You Look for in Your Rheumatologist?
“I?looked for?a gentle, confident, wise, reassuring bedside manner,”?says Seth D. Ginsberg, cofounder and president of the?Global Healthy Living Foundation, an advocacy group for people living with chronic illnesses.
“I was interested in someone I could relate to, have a conversation with, and explain my situation to in broader terms than just my aching joints. My wife came with me during the first visit and joined us in the exam room. Her opinion mattered, too,” says Ginsberg.
Udell agrees that one of the first things to consider is the doctor’s personality and how well it meshes with yours — especially if your disease is a serious, chronic one such as rheumatoid arthritis.“That’s because your relationship with the rheumatologist could be a very long one, which is one reason I went into this specialty,” Udell says.
And, he notes, the doctor-patient relationship should be nurtured?as time goes on. If there's an issue that the patient and physician don't see eye-to-eye on, for example, they need to discuss it.
Or you might want to be more aggressive about treatment options while your doctor wants to be less aggressive — this is also something you two must discuss, he says.
When You Know You Have the Right Match
Traci Lynn Martin, a neonatal ICU nurse and expedition kayaker from Lee’s Summit, Missouri, found out she had rheumatoid arthritis, she went to a few rheumatologists before she found the right chemistry.
“The first person I saw I didn’t like,” Martin says, “because I didn’t feel like he was listening to me. He had a formula with questions and it wasn’t personalized. It was important for me to stay active, to be able to do my triathlons, and long distance kayaking that I had done my whole life.”
Friends referred her to other specialists, but she knew right away when she found the right rheumatologist. “He sits down and doesn’t rush in and out and doesn’t leave the room until I am happy,” Martin says. “I walked out of there so happy after the first visit, I felt like I had someone who was listening to me for the first time since my diagnosis.”
What Are Some Red Flags to Watch Out for When Picking a Rheumatologist?
Be wary of someone who doesn’t look you in the eye; eye contact is crucial, Ginsberg believes.
If the doctor’s head is buried in your chart or electronic health record during your appointment, that’s a red flag. You want someone who relates to?you, not your chart or lab results, he says.
Another major red flag is when doctors, nurses, or other members of the office staff don’t respond to your phone calls.
How Can Working With a Rheumatologist Help You?
Rheumatologists understand the biology of?rheumatic diseases?and are well-equipped with information to target and treat them, notes Ginsberg. A family practitioner may not have the depth of knowledge about some of these syndromes.
The best case scenario is having a primary care practitioner as well as a rheumatologist who both regularly coordinate arthritis care, he says.
“As I was growing up, my pediatric rheumatologist used to send a report to my pediatrician after every visit. That made my file, back when they were kept in folders, very thick for both doctors. But it was important to have as much documented as possible,” he says.
Other Tips for Picking the Right Rheumatologist
“What I would suggest for anyone who is getting ready to see a new doctor is to sit down before you go and write down on a piece of paper why you are going and what you are hoping to accomplish with your visit,” says Martin. “And write down a list of everything that’s going on with you. If you have everything written down when they come into the room, I think the doctors themselves will sit down and be a little bit more patient. It pays to be organized and know what it is you want to talk to your doctor about.”
Other Treatment Options if You Struggle With Finding a?Rheumatologist
There has been a shortage of rheumatologists in America — as well as many other developed countries — for the last decade, and it’s likely to get worse before it gets better, says Vinicius Domingues, MD, a rheumatologist in?Daytona Beach, Florida, and medical advisor to CreakyJoints, an advocacy, education, and support group for people living with arthritis and rheumatic disease. But that doesn’t mean that you can’t get good treatment from your primary care physician if that’s what your situation requires. “The advancement in the medical community’s understanding about the causes and the treatments of arthritic conditions, as well as the evolution of telemedicine, has allowed primary care physicians to diagnose and treat most common forms of arthritis,” says Ginsberg.
Dr. Domingues also thinks there could be a positive future for telehealth, which is when patients receive health-related services and information via electronic information and telecommunication technologies.
“It will never replace an in-person doctor, but it may be an option for the future. And the American College of Rheumatology has good support groups. CreakyJoints also has forums and resources that should be explored,” says Domingues.