Who Can Help Me Get My Next RA Fix?

Tuesday morning I had a routine 6-month appointment with my rheumatologist. It seems that time flies between appointments and our main priority, besides seeing how my RA is doing, becomes to refill prescriptions and order another round of Rituxan. Since we moved to the 6-month schedule for Rituxan, as opposed to waiting until symptoms return, I have been able to achieve near remission and only rarely experience minor flares.

When my doctor and I have fewer RA-related topics to discuss, she moves onto other topics such as losing weight, exercising more, etc. I took her advice to heart last year and have lost 55 pounds so far by altering the way I eat, riding the exercise bike at home, weighing each day, and keeping detailed records of everything.

Our discussion at this appointment took a different turn. I learned that she is retiring.

RETIRING!! Wait, what, OH NO! She can’t retire. I’ve followed this doctor through three changes in practice. She is great about communicating with my other doctors and with me, having called me after hours on several occasions. She has been my only rheumatologist and she is my golden key to getting the care that I need. She’s awesome.

After I literally blurted out “oh no”, I quickly offered congratulations. It appears that I was supposed to get a letter from the office informing me, but apparently I did not. I am going to need a new rheumatologist, soon. In beginning my search here are some of my initial thoughts and inquiries.

1. Who are the local rheumatologists? My rheumy gave me a list which is very helpful.

2. Who participates in my insurance preferred provider network? Check insurance website.

3. Who has privileges at the local hospital infusion clinic where I’ve been receiving my Rituxan infusions for the past 5+ years? Insurance website provides this information for most doctors.

Then I called the infusion clinic to ask:

4. Who are the doctors in the area who send their RA patients to the clinic for Rituxan infusions? I presume that these doctors are Rituxan-knowledgable, Rituxan-comfortable, and less likely to argue when I ‘tell them’ what my preferred treatment plan continues to be during our initial get-to-know-you appointment.

But in calling the clinic, I learned another consideration:

5. Which doctors in the area continue to have hospital privileges because they chose to go through the extra training required to use the hospital’s updated electronic system?

6. When are the first available appointments for the 3 doctors who match the above criteria?

7. So, who are the doctors who can help me get my Rituxan infusions as close to on-schedule as possible since my doctor is retiring so soon?

I was mildly surprised that nothing about quality, skill, or like-ability had entered my thought process. Nothing about being able to work with my other doctors. Nothing about being familiar with my comorbidities. Nothing about establishing a good patient-doctor relationship.

The main consideration at this time is who can help me to continue to get my treatments in the same way I have for years at a clinic that has excellent facilities and where the nurses know me and are skilled to handle my challenging veins….and who is covered by my insurance policy.

I did learn that the clinic could fit me in within the next three weeks for infusions if my current doctor can forward orders to them ASAP. However, I’ve learned that even this has to be approved by my doctor’s colleague (who is also one of the 3 narrowed choices of possible replacement doctors) to submit the orders on her behalf.

Right now I’m in a holding pattern. Either I’ll be able to begin a round of infusions next week, or I’m going to have to wait until the New Year to get set up with a new doctor and risk losing this wonderful remission status during the busy holiday season. I’m really hoping to get a phone call soon telling me to schedule those infusions now.