RA & Your Medical Team: A Competent PCP Is Essential!
I feel as though I am making a major announcement when I tell you that I finally have a good primary care physician. It has been a long time since I have felt comfortable with any doctor, other than my rheumatologist and my orthopedic doctor.
Truth is, those of us with RA need a good primary care physician. We need someone who has access to all of our medical information. We need someone to help coordinate our care"a "general", of sorts.
My friend, Mischelle, an RN, is very happy for me. She has been asking me to shop around for a good PCP for a long, long time.
Here are some signs that you may need to change primary care providers:
- Your PCP spends less than five minutes with you
- Your PCP tells you he/she knows nothing about RA
- Your PCP seems afraid of you as a patient
- Your PCP tells you not to take your pain meds because they won’t really make you feel "good"
- Your PCP cannot be counted on to call in a Medol Pak if you are in a flare and you cannot reach your rheumatologist
- Your PCP cannot seem to get your blood pressure controlled
You may be shaking your head at my examples, but all of these examples came directly from my experience with my previous primary care physician. When I see it put down in black and white, I end up shaking my head at myself. What was I thinking? No wonder Mischelle was always talking to me about finding a good primary doctor.
The truth is, I wasn’t thinking at all. I let my RA overwhelm me. I needed to take a step back and really evaluate my medical team. Fortunately, I did and still do, have a wonderful, competent rheumatologist and orthopedic doc.
The good news is that I asked around about local physicians. One name kept popping up, and my friends and acquaintances were big fans of this woman PCP.
I made an appointment with Dr Denise, and I was stunned by the level of care I received. I felt as though I had found an oasis after wandering in the desert for way too long.
Dr Denise spent an hour with me on my first appointment. She prescribed a new blood pressure med combination, and it is working. I was really impressed when she went out of the room to call my cardiologist while I waited in her exam room. I mean, what doc does that these days?? Dr Denise does.
Dr Denise also told me she would be more than happy to take over my pain management. What??? I could hardly believe my ears.
At the time, I was had a script from my rheumatologist for Tramadol, and a script for Soma and T3 from my orthopedic doc. I was already impressed with this new doc.
Dr Denise said my specialists would probably prefer she take over my pain management, and I was more than happy to let her assume that role. She is managing my pain. Amazing"""".especially after my previous PCP didn’t even want me to take Tramadol. What a lack of understanding of RA pain that was!
I have had two other appointments with Dr Denise since my very first visit. She has not disappointed me yet.
I have been in a flare for almost two months. Actually, Orencia has failed. Dr Denise wanted to know why I had so many Tylenol 3’s left in my prescription bottle, which I had brought to my appointment.
I was "gun shy" and afraid of taking my breakthrough pain med because of the hoopla going on in this country about addiction to prescription drugs. I know better.
I know that only 3% of chronic pain patients become addicted to pain meds. I know I need those pain meds to function. I was just so afraid of being labeled a drug user. I was suffering when I did not need to suffer.
I have an appointment with my rheumatologist tomorrow. We will be charting a new treatment plan, since Orencia has failed.
In a few weeks, I will see Dr Denise again. She wants to know about the new biologic I will be taking, and about my current CRP levels. She is on top of things, and it is such a relief!
The lesson to be learned from my story is this: You need a good primary care physician. You deserve a good primary care physician who is going to help you when you need help. It isn’t an option. It is a necessity.
Vanessa wrote for HealthCentral as a patient expert for Rheumatoid Arthritis (RA).