What are the benefits of regular check-ups with your primary care provider? If you have psoriasis, isn’t it enough to see a dermatologist? If you have psoriatic arthritis, aren’t you covering all your bases by seeing a rheumatologist?
Not so fast. Specialists say that your primary care provider (PCP) is an invaluable member of your health care team – one uniquely positioned to see the whole picture and take care of your health on many fronts.
“People with psoriasis are at higher-than-normal risk for cardiovascular disease,” says Jeffrey Crowley, M.D., a dermatologist with the Bakersfield Dermatology & Skin Cancer Medical Group in Bakersfield, California. “Psoriasis often goes hand in hand with obesity, hypertension and type 2 diabetes – all risk factors for heart disease and stroke.” These and other risk factors are why primary care plays such an important part in your overall health.
If you have psoriasis
Here, Crowley offers his best tips for maximizing your time at your PCP’s office.
- Request referrals for all necessary screenings, including those for colon cancer, psoriatic arthritis and cardiovascular disease. You may want to look into getting a cardiac calcium score test, an inexpensive yet effective way of assessing your risk for heart disease and stroke.
- Seek your PCP’s guidance in matters of nutrition, exercise and other aspects of your lifestyle that require behavioral changes.
- Because alcohol may be a trigger for inflammation, ask your PCP about programs designed to help you limit your alcohol intake, if necessary.
Crowley realizes that some people with psoriasis rely exclusively on their PCP for all their medical needs. Often, that’s because they don’t live near a dermatologist, or lack transportation or adequate insurance coverage.
If you don’t have a dermatologist, keep in mind the following recommendations from Crowley.
- Learn to advocate for yourself. You may need to educate your PCP regarding treatment options for psoriasis.
- Try to have a consultation with a dermatologist at least once, and make sure to keep your PCP in the loop.
- Consider teledermatology, also known as “dermatology at a distance.” Powered by communication technology, teledermatology allows dermatologists to reach patients living in rural areas or far from their chosen specialist. While not always available, teledermatology programs have been cropping up around the country, making them worth a look.
If you have psoriatic arthritis
The complications and comorbidities (related diseases) of psoriatic arthritis can feel overwhelming to people with the disease, explains Christopher Ritchlin, M.D., chief of the Division of Allergy, Immunology and Rheumatology at the University of Rochester Medical Center in Rochester, New York.
“Type 2 diabetes, obesity, depression and anxiety are found at higher rates among people with psoriatic arthritis compared with the general population,” he says. “That’s why an ongoing relationship with your PCP is so critical.”
Like Crowley, Ritchlin encourages his patients to make good use of that relationship. “We specialists can get so busy with rheumatologic issues that we don’t always have time to treat the whole patient,” he explains.
Here, Ritchlin gives his top tips for making the most of your relationship with your PCP.
- Get regular check-ups. Your PCP will keep track of your vital signs as well as your blood pressure, cholesterol and metabolic indicators – the best way to lower your risk for diabetes and cardiovascular disease.
- Ask your PCP to refer you to a qualified mental health practitioner if you experience depression or anxiety.
If you don’t have a rheumatologist, consider the following advice from Ritchlin.
- Take the bull by the horns and learn as much as you can about psoriatic arthritis. Then share what you know with your PCP, especially when it comes to biologics.
- Visit a rheumatologist at least once, if possible. Just one consultation with a rheumatologist will go a long way – and your PCP will be empowered to deliver higher quality care with the input of a specialist.
“Telemedicine hasn’t caught on in rheumatology the way it has in dermatology – yet,” Ritchlin says. But stay tuned: More rheumatologists are reporting on their experiences with telemedicine, and the University of Pittsburgh Medical Center now offers a rheumatology telemedicine service. The future is just around the corner.
The National Psoriasis Foundation’s medically reviewed booklet outlines the most important questions to ask your PCP, tips to improve communication and includes a section to keep track of your treatments and pharmacy information.
By Margaret Willig Crane for NPF