What if RA was recognized as the medical emergency many doctors feel it is? What would that look like?
We all hope for a future where RA is cured, but that wouldn't make much of a post. So let's pretend that the cure is within sight, but not quite there yet.
Ideal PCP Referral
Imagine you go to your family doctor with odd symptoms of fatigue and joint pain. In this future, your primary care physician would be aware of the signs of inflammatory arthritis, immediately ordering blood tests to investigate further. These blood tests were developed to test for different types of inflammatory arthritis and have a very high at rate of accuracy. Two days later, your doctor calls with the result, gently telling you that all signs point to rheumatoid arthritis. They would also tell you that a referral has been sent to an excellent rheumatologist less than half an hour's drive from where you live and you have an appointment next week.
The next time you're at the computer, you notice an email from the rheumatologist's clinic with a welcome message, an introduction from your new doctor, as well as some basic information and list of questions for you to answer before the appointment.
You spend the week frantically googling RA. Although you're not happy that you have a chronic illness, everything you read online tells you that you should be okay. You've already made several new friends in the community who suggest some questions you could bring to the appointment.
Dream First Appointment
The rheumatologist's clinic is easy to find and there is plenty of parking close to the entrance. You notice that there is a subway stop right next door and decide to leave the car at home for the next appointment. When you step inside the building, you're struck by the light and warmth of the decor and instantly feel comfortable. The secretary greets you with a smile, gets you a cup of tea, and show you to a waiting area with comfortable chairs.
You don't wait long. The rheumatologist comes to get you in less than 10 minutes. Once inside the appointment, they review the answers you have submitted, as well as take the time you need to get your questions answered. You find out that although RA can't be cured yet, the field of rheumatology expects research to finalize the cure within the next 5-10 years. Until then, the rheumatologist will prescribe a medication to suppress your RA.
The blood tests your family doctor ordered not only indicated that you have RA, but also which medication will work best for you with minimal side effects. It's not cheap, but government funding will pay for what you need.
You're a little stunned, but the doctor explains that lawmakers realized that funding early and aggressive treatment of autoimmune diseases like RA would save society billions in healthcare costs and lost work hours. The sweeping Autoimmune Disease Reform Act of 2025 (ADAR) not only funds treatment of autoimmune diseases, but also eliminates the role of insurance companies, mandating that doctors are the best judges of what treatment should be used. Naturally, doctors' appointments and medical tests are also funded.
The Act also recognized that a good relationship between patient and doctor plays an essential role in achieving wellness. The doctor explains that if you'd be more comfortable with another doctor, you can call an independent office that will provide you with a list of all the rheumatologists in your area.
Your rheumatologist also mentions that although the medication will work quickly and eliminate most, if not all, symptoms of RA, you still have to get used to the idea of having a chronic illness. They explain that after your appointment, you will see a social worker who will help you access community resources and provide you with as much counselling as you need to adjust.
The ADAR enabled doctors to create a much more holistic model of treatment that recognized that when you have RA, your family and support network also has RA. That's why your family and close friends also will have access to counselling to help them understand the implications of the disease. Although your treatment is expected to minimize the effects of RA in your daily life, it will still have an impact due to taking medication, going to doctors' appointments, etc. The social worker will also be available to provide education to your employer and colleagues, at your request.
Given the genetic components of RA, testing is also available at no charge to your extended family. These days, excellent tests are available that can indicate who will develop RA several years before it happens. When someone is identified, they can receive treatment stopping the disease before it starts. Again, these tests are funded by the government, as pre-disease development identification and treatment saves society billions every year and enables many more people to live normal lives.
And that's just the beginning. What would you like to see in RA's future? Is there something I've missed for a person who is new to RA? What about people who've had RA for a long time, already experiencing damage and chronic pain?
I look forward to seeing your ideas
Lene writes the award-winning blog The Seated View. She's the author ofYour Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain and 7 Facets: A Meditation on Pain.