A common piece of advice to those who have just been diagnosed with rheumatoid arthritis (RA) is to "find a good rheumatologist," but what makes a specialist "good"? Do they give frequent flyer points at every appointment that you can redeem for gift certificates to the store of your choice? Do they wave magic wands that reduce your symptoms? If you're new to the medical world and already feeling overwhelmed by your diagnosis, it can be hard to know what to look for in a doctor. Here are a few suggestions:
Makes Time for You
All doctors tend to be busy, but once you're in the office, good doctors will take their time. Making time for you means that she focuses on you, making eye contact instead of having her nose buried in your chart. It means that your doctor will have good listening skills, helping you tell your story in a way that isn't rushed and without making you feel as if you're wasting her valuable time. Making time for you is one of the cornerstones of what's called "a good bedside manner" and creates an environment of trust, which is essential component of a patient-doctor relationship.
Is on Your Team
Living with a chronic illness means changing the way you interact with doctors, subtly shifting the decision-making role to you. After all, you are the one who has to live with this disease every day and you know better than anyone how your body reacts to different treatments. A good rheumatologist will respect that you're the leader of your medical team and will provide you with the information you need to make the decision that's best for you. He will support you in doing your own research, encourage you to ask questions and explain the pros and cons of various treatments so you can make a fully informed choice. A good doctor will know how to offer his opinion with the appropriate weight, i.e., he will know when to back off and when he, as your expert consultant, should strongly recommend a specific treatment. When you have a relationship based in respect and trust, you, as a patient, will also know when to insist on your way and when to follow the advice of your rheumatologist.
You will likely have regular appointments with your rheumatologist every 3 to 4 months or so and once your disease responds to treatment and stabilizes, you will probably not need to speak to your doctor more than that. However, if you start flaring, develop a weird side effect or for another reason need to speak to your doctor in between your regular appointments, good rheumatologists will be available, either to return a phone call or to squeeze you into their appointment schedule.
Cultivate your doctor's secretary -- although your doctor sets the tone in the office, the secretary is in charge of the appointment book and therefore is the person with the real power. Nurturing a positive relationship with her (they are most often women) by taking time to have a chat and a laugh when you're in the office will increase your chances of getting a quick appointment in a full schedule.
Will Be Compassionate & Resourceful
Having a chronic illness can be difficult and having a chronic illness that's unpredictable and painful can be a real drain on your emotional well-being and may create problems in personal relationships, employment, etc. A good doctor will understand this and will, by showing warmth and concern, create an environment in which you feel comfortable enough to talk about your fears and frustrations and safe enough to cry when things are really bad. And when you do, a good doctor will offer helpful tips and referrals -- e.g., to a counselor, occupational therapist, etc. -- if practical help will solve your problems or comfort and reassurance if that's what you need.
Has a Sense of Humor
Developing a sense of humor about your RA, its impact on your life and the reactions of other people can be one of the most effective ways of dealing with a chronic illness. Finding a doctor who is relaxed and human enough to bring humor into the consulting room (when appropriate) can go a long way towards creating an effective and trusting relationship between doctor and patient. Having an appointment where your doctor has listened to you, given you information, has shown you respect and had a laugh with you, will help you feel as if you and your doctor are on top of your disease, give you hope and help you remember that at the end of the day, there is still joy to be found.
If your first doctor doesn't meet your expectations of what a "good rheumatologist" should be, don't be afraid of getting a second opinion. If possible, interview a few alternatives. As in all relationships, it takes time and effort from both parties to build a good connection , but you should be able to tell fairly early on if she or he has potential. If you live in an area where your options to see another rheumatologist are limited, don't give up -- it's possible to "train" a doctor over time. Through good communication, subtle guidance and firm, but respectful sticking to your guns, almost any doctor can be taught.
You can read more of Lene's writing on The Seated View.