What is a Rheumatologist and what diseases does s/he treat?
Rheumatologists are sub-specialists of internal medicine and care for patients with systemic auto-immune diseases such as rheumatoid arthritis, lupus, vasculitis, gout and inflammatory diseases of the back. In addition, rheumatologists are trained to care for complicated musculoskeletal problems such as advanced osteoarthritis, injuries and tendinopathies.
Generally rheumatologists are required to have completed the following training in the Province of British Columbia; an undergraduate university degree, four years of medical school, three years of internal medicine residency training followed at least two years of rheumatology fellowship.
How can I find a Rheumatologist?
In order to see a Rheumatologist in BC, you need to be referred by your family physician. Access to rheumatologists in BC can be challenging, as estimates from the BC Medical Association indicate there are only 32 full time equivalent rheumatologists in the Province. As a result, upon receiving referrals from family physicians, many rheumatologists prioritize these referrals in order that patients with life threatening or damaging diseases are seen first. Unfortunately this means the wait to see a rheumatologist for more common musculoskeletal conditions may be lengthy or in some cases not possible. The BCSR is committed to addressing this problem and is working with various levels of government to try and increase access to care of British Columbians who suffer from rheumatologic conditions.
For a list of rheumatologists in BC, search the College of Physicians and Surgeons of BC’s website under “Find a Physician”.
What will happen when I see a Rheumatologist?
In most cases, you will have an initial appointment that may take anywhere from 30 minutes to an hour and will include a history of your present and past illnesses, a physical examination, and a discussion.
Many of the conditions treated by rheumatologists (like rheumatoid arthritis), are chronic conditions that requires ongoing management and follow up with your doctors and health care team. In those instances, ongoing follow up visits are often arranged with your rheumatologist and his/her team. That health care teams involves a number of individuals, including your family doctor, your rheumatologist, nurses, physiotherapy and occupational therapy.
Your family doctor is the quarterback of your overall care and receives input and recommendations from any other specialists you may be seeing.
Your rheumatologist is the doctor who helps you decide what are the best medication treatment options to manage your arthritis or autoimmune disease.
This is a rapidly evolving field and there are many medications to treat inflammatory diseases, some of which have been around for decades or others which are new and very effective.
Why would my rheumatologist have me speak with a nurse?
Many rheumatologists work closely with nursing staff to better manage concerns around inflammatory arthritis and autoimmune diseases.
Nurses in rheumatology can help with many aspects of care and might include:
- teaching around self administering injections as many of the medications are not available in pill form and need to be administered by the patient them selves at home
- giving intravenous arthritis medications in the office,
- providing important vaccinations like influenza and streptococcal vaccine
- counseling around pain and lifestyle management
Nurses can also help counsel in times of disease flares and are a key link with your rheumatologist.