How Can I Find the Best Rheumatologist? - WTOP News (2023)

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July 10, 2018, 8:00 PM

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Many different health conditions are associated with aging: Cataracts, diabetes, hypertension and dementia, for example, become increasingly common with age. Perhaps the condition most closely associated with moving on in years is osteoarthritis, a very common disease that results from a breakdown of joint cartilage and bone. This can lead to swollen, stiff and painful joints that impede normal activities. Virtually every person will develop osteoarthritis if they live long enough — it’s a simple case of wear and tear on the joints over time.

If you’re dealing with osteoarthritis, chances are good your primary care physician can help you manage the disease. But if you develop complications or have an especially severe case of this very common ailment, you may need the assistance of a specialist doctor who treats rheumatic disease — a rheumatologist.

(Video) Top 10 Best Rheumatology Hospitals in Chennai | Unique Creators |

But there’s more to rheumatology than just arthritis. Although osteoarthritis is the most common complaint rheumatologists treat, there are a wide range of so-called rheumatic diseases that a rheumatologist can help with.

[See: 10 Lessons From Empowered Patients.]

The term rheumatic disease refers to a collection of about 100 diseases that feature inflammation of the connecting or supporting structures of the body, such as joints, tendons, ligaments, bones and muscles. Rheumatoid arthritis, fibromyalgia and gout are rheumatic diseases. Certain autoimmune disorders, such as Sjögren’s syndrome and lupus, are also considered rheumatic diseases. The specialist who can help you cope with this wide range of sometimes very complicated conditions is the rheumatologist.

The American College of Rheumatology reports that “a rheumatologist is an internist or pediatrician who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and systemic autoimmune conditions commonly referred to as rheumatic diseases. These diseases can affect the joints, muscles, and bones causing pain, swelling, stiffness, and deformity.” Typically, a rheumatologist completes medical school and residency in internal medicine or pediatrics followed by a two or three-year fellowship in the subspecialty of rheumatology.

In finding the right doctor for your specific situation, you may have some challenges ahead, given that the ACR recently sounded the alarm over a coming shortage of physicians in the field. But it’s important to find a doctor with whom you’re comfortable, because you may be working with this person for the rest of your life; rheumatic diseases tend to be chronic ailments that require ongoing management.

When searching for the right doctor for your needs, Dr. Thomas Olenginski, a rheumatologist with Geisinger in Danville, Pennsylvania, says “the patient’s best resource is the doctor or medical team they’re seeing.” Ask your primary care physician for a referral, and find out who’s respected locally.

In assessing which doctor to see, Olenginski says there’s simply no substitute for experience. “You cannot underappreciate the importance of experience, because sometimes in our realm we’re asked to identify very unusual conditions we’ve only seen a few times. Sometimes it can take decades to see unusual things a few times.” He says he’s a better doctor today “than I was a year ago only because I’ve had experience and time to reflect and learn.”

Accessibility is another important aspect of finding the right doctor. “I commonly hear that someone has had to wait three to four months” for an appointment, Olenginski says. I saw someone yesterday who was referred to a different physician but couldn’t get in until December. I think accessibility is very important and the ability to develop a way to see people quickly, even when a practice is busy,” is important to providing patients with good care.

Before heading to the first appointment with a rheumatologist, there are a few things you can do to help make that meeting be as productive as possible. Dr. Wael Jarjour, professor of medicine and division director of immunology and rheumatology at The Ohio State University Wexner Medical Center in Columbus, says being aware of when symptoms began can be a big help in figuring out the right diagnosis and best course of treatment. “It doesn’t have to be the specific day, but roughly when certain things occurred, that’s very useful.” If your doctor provides a questionnaire to fill out prior to the appointment, that can also help guide the conversation in an initial meeting and get to answers faster. “Those questionnaires are very useful and a good starting point for the discussion in the appointment to learn about the history of the illness,” he says.

[See: 14 Things You Didn’t Know About Nurses.]

Also making sure all previous records have been received by the rheumatologist’s office ahead of your appointment can help facilitate a diagnosis while eliminating unnecessary or duplicate testing, Olenginski says. “For patients coming from outside [the Geisinger system] where there’s no connectivity to our medical records, I like to receive office notes and any testing and actual X-rays that have been used. They facilitate a more expeditious evaluation and reduce the need to unnecessarily order and duplicate tests. I don’t like to order tests when I don’t have to.”

Jarjour says it also helps if the patient has a clear understanding of the specific question they’re being referred to the rheumatologist to answer. “When a primary care or another specialist refers a patient to a rheumatologist, it’s very helpful for the referring doctor to tell the patient, ‘I’m referring you to this doctor for this specific question to see if they can help us with that.’ Sometimes the patient doesn’t know why they’re being referred,” so if the referring doctor hasn’t made that clear, be sure to ask.

With many rheumatic diseases, arriving at a correct diagnosis can take some time. Many different conditions can cause symptoms that mimic each other, so unraveling exactly what’s causing the problem sometimes requires intensive detective work. But Olenginski says most rheumatologists are “comfortable with diagnostic uncertainty. Patients don’t always leave with an absolute diagnosis. It can be many things that can be related to new patient signs and symptoms, so it might take a while to really define.” But an experienced rheumatologist can puzzle through the various inputs to arrive at the right diagnosis faster than a less experienced doctor, Olenginski says.

(Video) Top 10 Best Rheumatology Hospitals in India | Top 10 Rheumatologist | Unique Creators |

Tolerance of uncertainty and a willingness to collaborate with other experienced rheumatologists are both hallmarks of a good rheumatologist, Olenginski says. “The ability to be honest and say, ‘look, we’ve looked at you and we think it’s this condition but because of the nuances, I want to get another opinion from someone I know and respect,’ that’s going to help everybody,” he says.

Olenginski also recommends talking with your rheumatologist about other doctors you can see if you need to do so when you’re in another part of the country. Because rheumatic diseases tend to be more common among older adults who may be retired and spend the winter in warmer climates, it’s helpful if you can have a local doctor who will collaborate with your regular rheumatologist if you need to be seen physically while away from home.

Developing the right management plan for some rheumatic diseases may also require some patience on the part of patients, as it may take some trial and error to arrive at the appropriate treatment protocol. But specifically for diseases like lupus, rheumatoid arthritis and fibromyalgia, newer treatments are offering better outcomes for patients, Jarjour says. “Treatment for autoimmune diseases largely depends on suppressing the immune system. So, we used to do that in a very broad way that actually was associated with significant side effects and toxicity for the patient. Nowadays we have a lot more targeted therapies that really work a lot better than some of the old drugs we used to have. We can treat patients, for example, with rheumatoid arthritis with drugs that help them significantly in making their disease go into remission while also improving their function substantially.”

[See: 10 Questions Doctors Wish Their Patients Would Ask.]

Although the noted shortage of rheumatologists, which is more severe in some parts of the country than others, may limit the number of options you have, it’s still important to think about whether you think your doctor understands your condition and whether the rheumatologist you’re seeing is the right fit for you. “I think the most important element is to be a good listener,” Jarjour says. “Listen to your patients as they talk and try to understand what their history is and what brings them to see you.”

He says skill when conducting physical examinations can also be a big help in determining the correct diagnosis. “In many specialties, we depend significantly on our ability to find abnormalities on a physical exam that lead us to arrive at the correct diagnosis.”

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FAQs

How do I find the best rheumatologist? ›

8 Tips for Choosing a Rheumatologist
  1. Get Referrals. ...
  2. Research the Rheumatologist's Credentials. ...
  3. Consider the Rheumatologist's Experience. ...
  4. Consider Gender. ...
  5. Ask About Telehealth Capabilities. ...
  6. Evaluate Communication Style. ...
  7. Read Patient Reviews. ...
  8. Know What Your Insurance Covers.

Which DR is best for rheumatoid arthritis? ›

Rheumatologists – Rheumatologists specialize in musculoskeletal diseases and autoimmune conditions. They treat all types of arthritis, including osteoarthritis, rheumatoid arthritis and psoriatic arthritis.

What is the best doctor to see for arthritis? ›

Rheumatologists are specialists in arthritis and diseases that involve bones, muscles and joints. They are trained to make difficult diagnoses and to treat all types of arthritis, especially those requiring complex treatment. You may be referred to an orthopedist if you have a type of degenerative arthritis.

Does a rheumatologist deal with all types of arthritis? ›

All the systemic autoimmune diseases can cause inflammation of the joints, or arthritis. Therefore, rheumatologists are considered the experts in treating this group of disorders.

Why is it so hard to find a rheumatologist? ›

Specialist Supply and Demand Issues in Arthritis Care

The baby boomer rheumatologists are largely male, and the younger doctors coming into the field are mostly female. Women tend to see fewer patients per week because they're more apt to work part-time, and to spend more time with individual patients.

How do you permanently treat rheumatoid arthritis? ›

Although there's no cure for rheumatoid arthritis, early treatment and support (including medicine, lifestyle changes, supportive treatments and surgery) can reduce the risk of joint damage and limit the impact of the condition. Your treatment will usually involve care from your GP and several different specialists.

What is the safest drug to treat rheumatoid arthritis? ›

Methotrexate is widely regarded as one of the safest of all arthritis drugs, though it carries some potential downsides. Gastrointestinal symptoms such as nausea and vomiting are its most frequent side effects.

Which Mayo Clinic is best for rheumatology? ›

Mayo Clinic in Rochester, Minnesota, is ranked among the Best Hospitals for rheumatology by U.S. News & World Report.

Can osteoarthritis be mistaken for rheumatoid arthritis? ›

Osteoarthritis and rheumatoid arthritis can be mistaken for each other because both are characterized by swelling and inflammation. However, rheumatoid arthritis is different because in this condition, the body's immune system attacks the joints. This can happen suddenly and cause severe inflammation.

What type of arthritis is the most painful? ›

Rheumatoid arthritis can be one of the most painful types of arthritis; it affects joints as well as other surrounding tissues, including organs. This inflammatory, autoimmune disease attacks healthy cells by mistake, causing painful swelling in the joints, like hands, wrists and knees.

What triggers osteoarthritis flare ups? ›

The most common triggers of an OA flare are overdoing an activity or trauma to the joint. Other triggers can include bone spurs, stress, repetitive motions, cold weather, a change in barometric pressure, an infection or weight gain.

What is the difference between osteoarthritis and rheumatoid arthritis? ›

Osteoarthritis, the most common form of arthritis, involves the wearing away of the cartilage that caps the bones in your joints. Rheumatoid arthritis is a disease in which the immune system attacks the joints, beginning with the lining of joints.

What blood tests are used to detect rheumatoid arthritis? ›

Some of the main blood tests used include: erythrocyte sedimentation rate (ESR) – which can help assess levels of inflammation in the body. C-reactive protein (CRP) – another test that can help measure inflammation levels.

What questions should I ask my rheumatologist? ›

Questions to Ask Your Rheumatologist
  • Are my joint symptoms likely caused by my inflammatory arthritis? ...
  • What are the most common causes of my inflammatory arthritis occurring outside of my joints? ...
  • Do I need to be on a DMARD? ...
  • What can I take for flares of arthritis symptoms?
2 Jul 2019

What blood tests does a rheumatologist do? ›

BLOOD TESTS:
  • Complete Blood Count (CBC): includes white blood cell count, hematocrit, and platelets. ...
  • Creatinine (Cr): measures kidney function.
  • Liver Function Tests (ALT/AST): measures liver function; can be elevated due to medication toxicity.

› doctor-patient › what-is-a-rheum... ›

“A rheumatologist is an internist or pediatrician who received further training in the diagnosis (detection) and treatment of musculoskeletal disease and system...
It's important to treat your RA early to prevent damage to your joints. It's best to see a doctor who knows rheumatoid arthritis inside and out, even if...

What questions should I ask my rheumatologist? ›

Questions to Ask Your Rheumatologist
  • Are my joint symptoms likely caused by my inflammatory arthritis? ...
  • What are the most common causes of my inflammatory arthritis occurring outside of my joints? ...
  • Do I need to be on a DMARD? ...
  • What can I take for flares of arthritis symptoms?
2 Jul 2019

What are the 4 stages of rheumatoid arthritis? ›

The four stages of rheumatoid arthritis are known as synovitis, pannus, fibrous ankylosis, and bony ankylosis.
  • Stage I: Synovitis. During stage I, you may start having mild symptoms, including joint pain and joint stiffness. ...
  • Stage II: Pannus. ...
  • Stage III: Fibrous Ankylosis. ...
  • Stage IV: Bony Ankylosis.
12 Oct 2021

What autoimmune disease does a rheumatologist treat? ›

Mayo Clinic rheumatologists have expertise in the treatment of inflammatory diseases of blood vessels (vasculitis) and systemic autoimmune connective tissue diseases (for examples, lupus, scleroderma).

Do Rheumatologists treat fibromyalgia? ›

However, because fibromyalgia can cause chronic pain and fatigue similar to arthritis, some people may advise you to see a rheumatologist. As a result, often a rheumatologist detects this disease (and rules out rheumatic diseases). For long term care, you do not need to follow with a rheumatologist.

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5. Rheumatology क्या है ? What is Rheumatology in Hindi. Dr. Suvrat Arya - Rheumatologist.
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