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What Makes a Rheumatologist Appointment Positive and Effective?
Too often, people living with rheumatoid arthritis come away from their doctor appointments feeling dissatisfied — or even worse — like they don’t know what just happened. It is important to have an effective appointment. By “an effective appointment,” I mean that you need to accomplish certain things while you are with your rheumatologist and not allow time to tick away, nor overlook what needs to be discussed. I know what you are thinking right now: The doctor controls the appointment. Yes, this is true, to some degree. But there are also things you can do to ensure an effective appointment.
Enter the Room With a Prepared List of Questions and a Notebook
Be ready. I can’t emphasize that enough. Be ready for your appointment by preparing a list of questions for your rheumatologist. Remember that time is limited, so prioritize your questions to be sure that the most important questions are answered first. In an effort to get all of your questions answered, be reasonable with the number of questions you have on your list and do what you can to move the dialogue along once you get the desired answer. Also, bring a pen and small notebook with you so you will be ready to jot down any pertinent answers or suggestions your rheumatologist provides. RELATED: A Laugh-Out-Loud Author Takes on a Deadly Serious Topic: Fighting for Health Insurance Coverage This seems like obvious advice, to have a list of questions and to bring a notebook, since most people assume they will remember. It’s a tough lesson to learn that it’s difficult to retain everything a doctor says to you.
Stay Focused and On-Task
I will always remember a family member who, years ago, chatted up her doctor about what he thought of Michael Jackson’s sad and sudden death. They talked the entire time about that and spent little time on my family member’s condition — and she left without her refills, too! Moral of the story: A doctor’s time is not limitless and it is easy to get derailed unless you are prepared.
Answer Honestly to ‘How Are You?’
When your rheumatologist enters the exam room, expect to be greeted with a generic “how are you” or similar words. Use that as your opportunity to indicate that you have had changes since your last appointment or that you have some questions. That sets the tenor for the appointment as it lets the doctor know right away there is ground to cover. RELATED: Can You Overcome Rheumatoid Arthritis Sleep Trouble? Too often, people automatically respond to “how are you” by saying “fine” or “doing okay.” It has become habitual to do that, but it doesn’t work well in a doctor’s office.
Discuss New Symptoms or Other Health Concerns
After the generic greeting is behind you, your rheumatologist may ask for more details regarding what has changed since your last visit. If you keep a symptom diary, produce it and go over the important aspects. If you don’t have a symptom diary, hopefully you have in your notes what you want to be sure to mention. RELATED: The Benefit of Failed Rheumatoid Arthritis Treatments Your doctor doesn’t read minds, so it’s your responsibility to bring up significant changes or concerns. It doesn’t work in your favor to be shy or embarrassed, or to withhold information for any reason. Give your rheumatologist the necessary information so that he or she can help you.
Karen’s Experience With Long-Term Rheumatoid Arthritis Treatment
Karen Palmer, a rheumatoid arthritis patient in Mason, Ohio, says, “My rheumatologist trusts what I tell him about what is going on. We rely mostly on symptoms. We will generally have a discussion of options before jointly deciding the next move. I had a lot more questions when I was newly diagnosed than I do now more than 30 years in, but I still make sure I understand everything we discuss.”
Review Test Results to Prepare for Discussion
If you had tests ordered, be sure you go over the results and what they mean. While it seems like that is the doctor’s responsibility, and it is, a doctor is sometimes at the mercy of his office staff. In case the results are not presented to you, know what you had done and know it is perfectly appropriate to ask for the results.
Get Printed Copies of All Test Results
Be sure to get printed copies of all test results, including laboratory tests and imaging studies. That goes for normal, as well as abnormal, results. Keep the results as part of your complete medical history. If the time comes when you need to look back, you will easily be able to see when things changed or how well you managed the disease while on particular drugs.
Review Your Current Medications and Obtain Refills
Before you go to your appointment, check which medication needs a refill. If you are not on top of it, you or your pharmacy will have to obtain it later. It goes much smoother for all concerned if you are prepared. Review your current medications with your doctor. Know why each drug is prescribed and tell your doctor if you think any are not as effective as you had hoped or expected. For example, if you are prescribed pain medication but your pain is not well controlled, perhaps there is a better option which needs to be considered.
Discuss Possible Adjustments to Your Treatment Regimen
It is not unusual for your rheumatoid arthritis treatment to move beyond medication alone, especially as the disease progresses. You may need a consultation with a physical therapist to assess your physical limitations. You may be taught exercises that you can continue at home, which is vital to improvement with physical therapy. You may need to consult an occupational therapist to evaluate your functional limitations. You may also need to consider assistive devices or mobility aids. You may need other specialists if comorbidities that are common with rheumatoid arthritis develop. Realize that rheumatoid arthritis is not a static disease — it does and will change. As those changes occur, be prepared to discuss adjunctive treatments and appropriate treatment changes with your rheumatologist.
Double-Check Your Appointment List
As your allotted time winds down, look over your list of questions and be sure you addressed everything you intended to discuss. If you have made medication changes, ask your doctor what you should expect — when you should expect to see positive change or what you should do if symptoms worsen. Coronavirus and the global pandemic changed just about every aspect of daily life in 2020 and healthcare was no exception. While face-to-face interactions were limited to contain the spread of Covid-19, technology played a bigger role than ever before in order to maintain a connection between doctors and their patients.
Telehealth Became the New Normal During the Pandemic
First, let’s understand the terminology. As explained by the American Academy of Family Physicians, telemedicine refers to the practice of medicine using technology to deliver care at a distance. In other words, doctor and patient are in different locations and use either the telephone or computer to communicate. Telehealth is a broader term which includes the clinical services of telemedicine, but also may include nonclinical services (such as provider training). RELATED: What Telemedicine Can and Cannot Do for People Living With Rheumatoid Arthritis During the Pandemic As the Arthritis Foundation explained, telemedicine was never widely accepted prior to the COVID-19 pandemic. There were barriers, including insurance, the Health Insurance Portability and Accountability Act (HIPAA), and licensing issues. But it became a necessity, and it has been a lifesaver. That said, whether your rheumatology appointment is face-to-face or via telemedicine, all of the aforementioned advice applies. Be prepared, prioritize, and accomplish what you need to during your appointment time! RELATED: Telemedicine for Physical Therapy: It Works!
The Opioid Epidemic Has Changed the Way Some Rheumatologists Prescribe Pain Medication
If you have been prescribed pain medications by your rheumatologist routinely as part of your treatment regimen for RA, you may be faced with more changes. The opioid epidemic in the United States caused the Centers for Disease Control and Prevention (CDC) to issue prescribing recommendations for opioid drugs. There has been strict interpretation of those guidelines, and some states have created new laws affecting how opioids are prescribed. Consequently, some rheumatologists have reduced the amounts of pain medications they are willing to prescribe. Others have turned it over completely to pain management doctors. If this may impact you, discuss it with your rheumatologist so you understand the office policy and know what to expect.
Bottom Line Tips for Effective Appointments With Your Rheumatologist
Be prepared.Be respectful of your doctor’s time.Be aware of your role in a successful doctor-patient relationship.
Remember, you are not your doctor’s only patient. This is the case whether you are face-to-face or utilizing telemedicine.
