A Good RA Doctor Is Hard to Findby Lene Andersen, MSW Patient Advocate
When you have rheumatoid arthritis (RA), it’s important to be treated by a rheumatologist — a specialist in treating musculoskeletal diseases, such as the different types of arthritis. Finding a doctor — let alone finding the right doctor — can be challenging. It's almost like dating. Sometimes you have to try out several doctors before you find "the one.” Your doctor may be one of the longest relationships of your life, so it’s important that the two of you can work well together.
The referral from your family doctor
If your family doctor suspects you might have a type of autoimmune arthritis, they will refer you to a rheumatologist, who can officially diagnose you with RA. If all goes well, you and your specialist will be able to work together as a team. However, sometimes the rheumatologist may not be able to diagnose you, or the two of you are perhaps not a good fit. Whatever the cause, you may want to look for another doctor.
What’s a good rheumatologist
What makes a good rheumatologist isn’t just their skill and knowledge. It's incredibly important that they take your concerns seriously, and they both listen to and hear you. They should answer your questions with care and attention, and meet you where you are. That is, your priorities for your life are what should drive the team’s efforts. As well, they should also be available for consultation in between appointments — after all, you have RA all the time, not just at your scheduled appointments.
It’s a mutual relationship
If you have a doctor that you can be serious with when needed, and crack jokes with along the way, that's the sign that you're with the right person. Ultimately, your relationship with your doctor should be mutual, not one-sided. You should feel like you have some measure of control over your care and your health, and your doctor should not feel like a stranger to you, nor you to them, when you have an appointment.
Reasons to look for a new doctor
If you don't feel you can be open and honest with your doctor, for any reason, it's probably time to look for someone new, especially if you feel rushed, dismissed, or belittled by your doctor. It’s important to feel confident in your care and empowered to follow your treatment plan. Finding the right doctor could be one of the best things you ever do for yourself.
Where to look for a rheumatologist
The first person who can help you in your search for a new rheumatologist is your family doctor, who should be able to refer you to someone new. You can also call your insurance provider or hospitals in your area to ask for a list of rheumatologists close to where you live. Someone you know who also has RA may be able to give you a recommendation, or you can look for a rheumatologist in your area on the American College of Rheumatology website.
What if you can’t find a rheumatologist in your area?
Sometimes, it can be hard to find a rheumatologist near you, especially if you live in a rural area, or the doctors near you are not taking new patients. It may be necessary for you to travel several hours to see your doctor and some people even travel to a different state. Although this can be a challenge, keep in mind that you usually only see your rheumatologist two-to-four times a year.
Creative ways to connect with your rheumatologist
If you live far away from your rheumatologist, talk to them about alternate ways to connect. You may be able to contact them by phone or email to ask questions in between appointments. As well, if you experience an RA flare, you can’t just pop into their office for help. They need to be able to treat you long distance at times, or perhaps work with your family doctor as a liaison.
What if I can’t get another rheumatologist?
You may find yourself in a situation where you have to work with the rheumatologist you were given. In such cases, it can be worth it to spend some energy working on the relationship. Remember that your doctor is a human being and therefor capable of change. Educate yourself about RA and practice self-advocacy skills to learn to be more assertive — not aggressive — in your appointments. You may also want to bring a friend or family member as moral support.
Working on the relationship
Your doctor usually only sees you for a short time, making it difficult to address anything but the most urgent issues. You may want to book a double appointment with them to allow both of you more time to talk. Be as honest and polite as you can about your life, your needs, and what you need from them, even if that goes against their recommendations. Cut each other some slack — developing a good relationship with someone you might only see four times a year can take some time, but it is possible.
If, despite everything, you cannot find a rheumatologist, there are other options. Your family doctor may be willing to be a stand-in. As well, another type of specialist, such as an orthopedic surgeon, or another healthcare provider, such as a rheumatology nurse or nurse practitioner, may also be able to provide your treatment. Of course, having a rheumatologist is ideal, but if that is impossible, finding another provider who is able to oversee your care can meet your needs.