Which Type Of Doctor Should I See For My Rheumatoid Arthritis?

Most people with RA are treated by either an internist or a rheumatologist. Who you choose to be your treating physician depends on many factors:

Most people with RA are treated by either an internist or a rheumatologist.

  • The doctor's training and experience

  • His or her board certification

  • The proximity of the physician's office to your home

  • Whether the physician participates in your insurance plan

  • The doctor's reputation in the community

  • Your ability to build a trusting relationship with the physician

  • The doctor's ability to speak your native language or understand your culture and customs

While many of these issues do not necessarily bear directly on a doctor's knowledge or clinical abilities, patients often choose a doctor based on what is most important to them. The issue of which type of doctor a patient with RA should see for treatment has been examined in the medical literature, and differences in care and in the outcomes of patients have been noted.

In studies of RA treatment practices, as compared to the care rendered by internists, rheumatologists treated patients more frequently with intensive therapies, including disease-modifying antirheumatic drugs, immunomodulators, and tumor necrosis factor (TNF) inhibitors (Part 5 of this book discusses the medications prescribed for RA in more detail). Furthermore, patients who were treated by rheumatologists were more likely to be referred to specialists such as rehabilitation doctors and orthopedic surgeons. As a result, these patients received more joint injections and joint replacements than their counterparts who were treated by internists and general practitioners. Overall, being treated by a rheumatologist was associated with less RA-related disability. One medical study showed that the tendency to become disabled over time was also higher among patients who made fewer than 7 visits per year to their physician than among patients who made 7 to 11 visits annually. This finding suggests that patients might have had less disability if they had visited their rheumatologist more frequently.

Tumor necrosis factor (TNF)

A protein that plays an early and major role in the rheumatic disease process.

The more intensive level of care rendered by rheumatologists may result in improved symptoms and fewer visits to the hospital for patients with RA. Not surprisingly, however, this more intensive management leads to significantly higher costs than the costs for patients who are treated by internists.

I have always been under the care of a rheumatologist and advise anyone with RA to do the same for many reasons. When I was going through my bypass problems I was surprised to learn that the surgeons did not know the makeup of my RA meds. They had to contact my RA doctor for clarification. Rheumatologists are more aware and understand your symptoms thus provide a higher quality of care. Let's face it, that's their specialty.