When you have a rheumatic disease, your relationship with your primary care physician (PCP) is more important because they are part of your disease-management team. Being more selective about your PCP can improve your satisfaction with your overall healthcare and improve management of your condition.
Reducing Access Problems
Access to a rheumatologist can be difficult for some patients. One concern is living in an area where you must travel great distances to reach a specialist, but things are also difficult when there are few rheumatologists in the area and the few specialists available are often backlogged with patients. This is where your PCP can not only help with managing your disease in the initial phases but also be a good resource when you must wait months for another appointment with your rheumatologist.
Your PCP should feel comfortable working with your rheumatologist to manage your disease and not defer all of your concerns to the rheumatologist. Some PCPs, especially those specializing in internal medicine, are familiar enough with rheumatic diseases that they feel comfortable prescribing disease-modifying drugs to start patients on a regimen before damage occurs or changing the medication if it is not working.
Dealing with Potentially Urgent Matters
The process of managing medications associated with rheumatic diseases does not always go smoothly. Many patients who visit a rheumatologist only see the specialist once every six months and may have appointments with a nurse or nurse practitioner halfway between these visits. With months between appointments, this is ample time for new symptoms to appear or for you to experience concerns with your medications.
Although your first point of contact should be your rheumatologist, you should feel comfortable enough expressing any concerns to your PCP. At a minimum, they might make suggestions on what they feel like is an urgent concern and should be evaluated in the emergency room. Additionally, since it is much easier to obtain a walk-in appointment with a PCP than a specialist, this can make the difference between having lab work or other tests within a matter of days or waiting for the same tests to be ordered by a specialist weeks later.
Doing Simple Procedures
In-office procedures are important for managing some rheumatic diseases, mainly those affecting the musculoskeletal system. Although doctors are trained to administer steroid injections and other injectable medications to help reduce joint pain and inflammation, not all perform injections. It is in your best interest to find a PCP who is willing to perform steroid injections when necessary. Not only does performing injection in-office hasten to process to pain relief, but it may be less expensive for you. The same injection done by your PCP may be less expensive than when it is performed by your rheumatologist or if you were referred to an orthopedist or outpatient center.
Addressing Multi-System Concerns
Unfortunately, your rheumatologist may be more focused on your disease process than how it affects your entire body. This can lead to problems in the future as other concerns creep up. Since your PCP is trained to identify any number of problems, they are more likely to catch additional problems in the early stages. For example, some medications used to treat rheumatic diseases can significantly impact your weight, blood glucose, and blood pressure. Your PCP is more likely to notice trends in your blood work or other measurements, even if they are within normal range.
A normal fasting blood glucose is less than 100. If your rheumatologist, who sees you sporadically, notices your blood glucose is 95, it may not seem like a problem because it is within normal range. However, your PCP, who has a longer history with you, may notice your fasting blood glucose is typically in the low 80s and see the trend of your numbers creeping toward being pre-diabetic.
Since rheumatic diseases are a chronic and progressive concern, you should make every effort to find a PCP who is engaged in your care. A PCP who is willing to fill voids can help you achieve better disease management and pain reduction while reducing unnecessary costs for common procedures. Make an appointment with a PCP at an organization such as Rural Health Services Consortium Inc. to get to work on managing your healthcare.