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question, rheumatologist visits.

Posted , 7 users are following.

gemma83759
gemma83759

Just a question to ra diagnosed folks.

Is it the norm to only see ur rheumatologist to either increase or change ur medication? And be told to see ur own gp for anything else ra related in the meantime. I've a good rapport with my rheumatologist but don't get to see her as often as I'd like. During my last visit she changed my medication from methotrexate to sulfazalazine then discharged me from the clinic. Several years passed and after too many flare ups, continued fatigue and malaise my gp referred me back. My app came in for this week. When I went I could see that I was classed as a new patient again. Currently waiting on starting leflunomide. She's said when u take this if u encounter any problems go directly to ur gp!!

Is this normal or does any of u see ur rheumy regularly, even yearly for a catch up just to stay as a patient which is what I'd prefer to do?

0 likes, 14 replies

14 Replies

  • cheria
    cheria gemma83759

    Posted

    No this is not at all what an RA doctor does.If there are problems with the prescribed RA medication, the RA doctor makes an appt to talk with you to talk about what to try next. Definitely discharge this RA doctor and replace her. The problem sometimes is though, is that there is a shirtage of them in an area. Call another and ask if they will accept new patients. Your records will be requested from them by the new RA doctor. If there are medical problems not related to the RA treatment plan, then your GP would be the dr to go to.
  • barbara58180
    barbara58180 gemma83759

    Posted

    I live in the US and that is not normal. The Pheum-dpes everything related to that disease,

    Good Luck, maybr find a new doctor.

  • Light
    Light gemma83759

    Posted

    Highly unusual!

    But there are shortages of rheumatologists.

    As long as your GP is monitoring your bloods every two or so months, that is probably the most important thing. But you should see your rheumy as soon as  anything goes off kilter and I'd include increased flares in that.

    I'd imagine it would in part depend how familiar your GP is with RA. Many have barely come across it. But it's not an uncommon disease and there are some who are quite up to scratch.

    If she can monitor your blood then she'll be alert to anything that might be going wrong in relation to the drugs, at least.

     Asking your GP why you cant see the rehumy more often seems a perfectly reasonable question.

    • cheria
      cheria Light

      Posted

      If the GP is monitoring blood levels they do need to be able to treat properly and have a broad base of information on RA which they are typically not trained or licensed to do.

      Your GP often needs to give the referral and insurance authorization for the reumatologist.. So many visits yearly (calls to the nurse for needed help inbetween do not count towards this) and if more visits are needed, the GP can request them for authorization from your insurance carrier..

    • Light
      Light cheria

      Posted

      I may be wrong but I got the impression Gemma is in the UK. Not sure it's so easy to fire one and get another rheumy, but I've never tried it myself.

      I agree that if she's uncomfortabe with it, then she should try to move.

    • cheria
      cheria Light

      Posted

      Yes its very easy as long as you have another to go to within your area...we are not working for dictors..they are essentially working for us..we do have free will and choices as adults..
    • gemma83759
      gemma83759 Light

      Posted

      Hi thanx to everyone for ur thoughts and comments about my question. It was more of a thought posting the question. I am in the UK and am overall pleased with my rheumatologist, I'd just like to b able to see her more often than I seem able to. I know that after I start leflunomide she'll discharge me again and if it all falls apart my gp will have to refer me again which means waiting 19 weeks to see her!! I think it's madness to b regarded as a new patient every time I go and having to wait so long. It doesn't help with the feeling isolated most of the time. Onward and upward. Thanks to u all. G. Xx
  • frances85589
    frances85589 gemma83759

    Posted

    I have my bloods done monthly at my GP and results are dent to RA consultant but I still see my consultant regularly usually 3 monthly or even more regular if have problems.See RA for screening for new drugs too.I also can ring Specialist nurses with any problems thou don't recommend them.I like my consultant and he had always been sympathetic and kind to me and continues to try me on different drugs.
  • C2Anna
    C2Anna gemma83759

    Posted

    Hi Gemma, this makes no sense at all to me that you would be 'discharged' from RA services, and have to start all over as a new patient.. waiting an extreme amount of time.  If she is going to prescribe RA medication for you, she should be monitoring you, as you are still her patient.. and if you need more visits while you are her patient, you would just have your GP send an authorization to your insurance company, to authorize more appts.. but you would stlil be a patient.. just needing authorization for more appts during the year.  This is the way it is done in my state.  To give you a drug and than throw you to the curb with managing your illness makes absolutely no sense at all.  Can you locate a different Reumatologist who would keep you as a patient, and then just get more visits authorized when you needed them???
    • gemma83759
      gemma83759 C2Anna

      Posted

      Thanx for replying I'm now aware that what's happening to me is not the norm. I went this week to see the rheumatologist, I'm waiting on starting leflunomide. My next app at the rheumatologist is November!!! that'll b 7 months after starting new meds. I'll need to get bloods done every 2 months in the meantime at my gp. After the November app I'll b discharged from the rheumatologist again and on my own again. I can go to my gp if I can get an app but if he needs to refer me I'll have to wait 19 weeks by which time things might have settled down again!!! It is madness. I'd prefer to see her more regular I think I'd feel safer too. Thanx again. G.
    • cheria
      cheria gemma83759

      Posted

      I think what you would do is call thr RA office if u have any trouble inbetween now and your next appt and they will see you. If more appts are needed, an authorixation can be made for more visits. This is a disease to be managed nit a one time sickness and im confused at the lack of consistant investment in you as an RA client. It may be that you need to ask to subscribe to RA doctor visits as needed to keep them going (it is not cured or gking away so ask wht you are being dischsrged with long waiting periods of time inbetween for medicine changes to be made?? This causes extreme damage to the body and joints!!!) from your reumatologist and ask him what is needed to keep him from discharging you as a patient with a lifelong active and changing disease where consistant care is needed to manage this .lifelong disease This disease is not easily managed and not making care and treatment available to you in a consistent basis is extremely inferior. This sounds like maybe your GP is not making the correct authorization from your insurance company for you??
    • cheria
      cheria gemma83759

      Posted

      If you cannot get correct authorizations from your GP for consistant year round case management without being discharged, ask WHY? It sounds like your GP is not making the necessary renewal of your authirization to keep your RA care managed by the reumatologist. Ask to have your authorization for RA care renewed so it does not lapse, and find out when to request the renewal. It sounds like your GP is not requesting the correct amt of visits and sustained care from the insurance company. You can ask questions including from your insurance co to make sure your lifelong needed RA care dies not lapse or cancel.if your GP will not make correct ir consustant authorizations for consistant care, i hope you will find another GP! ER visits are also another option for emergency managed medicine care during lapses until you get this insurance and authorization issue resolved.
  • tammierick
    tammierick gemma83759

    Posted

    I find that very strange. The only thing my rheumy will suggest my GP is if i have an infection. Otherwise she follows me with blood work meds everything. Thats what rheumys do the follow u for RA.
  • cheria
    cheria gemma83759

    Posted

    This appears to be about your GP making correct and consistant authorizations and the insurance company requurements to keep RA case managenent ongoing without interruption of case managenent. Ask questions and see if u can get consistant authorizations needed for this lifelong changing disease. If you cannt get what you need from your GP for these authirizations please change either doctors or insurance company. Ask questions to clarify what is going on.
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