I had a rheumatologist 10 years ago. He was the one who gave me a definitive diagnosis after 15 years of having a wrong diagnosis. He up and left town, moved back east. My primary physician took over and continued the medications the rheumie had prescribed, treating flares as they occurred with a prednisone burst. This was adequate for 10 years. Then, at the first of this year he simply left his practice giving no notice to his patients. It broke my heart. He was great!
After a time he was replaced by the governing umbrella corporation with a nurse practitioner, a temporary replacement. No one knows when a new doctor will appear. This is not so good for someone with a chronic condition. I call a different clinic in town. Voila! They are taking new patients -- however the first available new patient appointment was not available until May (as I write it's mid-February). I took the appointment anyway figuring there must be a current Dr shortage and I'd better get what I can, when I can.
To cover my bases, I check my insurance rules and they allow self-referral to specialized doctors so I called the rheumatologist's office for an appointment. They won't see a new patient without a Dr's referral. Neat, I don't have a Doctor.
This week I see the temporary nurse practitioner to ask for the referral to the rheumatologist. Next week I see the movement specialist (psychiatrist) for my other chronic condition. Sure hope he's still there.