My Doctor and Me: A Love Story
Dr. Steve* (*not his real name) is my rheumatologist. If he weren’t my doctor, we could be friends. We talk about everything: holidays, aging parents, and our dream cars. He remembers the car I drive and my passion for Dunkin’ Decaf. We have serious talks about patient access to healthcare, and we laugh about how old we keep getting. And in between, he treats my RA: aggressively, with great intelligence and thoughtfulness, and he always collaborates with me, asking for my opinions and taking my concerns seriously. He is the doctor of my dreams.
It wasn’t always like that. In fact, the process of finding a rheumatologist once felt to me an awful lot like the experience of people seeking a spouse. I kissed a few frogs on the way to Prince Charming, too. Let me introduce you to a couple of them.
There was the old school doctor
My first, Dr. Don*, was old school: clinical, detached, always frowning. I told myself I didn’t need a charmer. What I needed was a scientist—someone who knew every treatment as it came to market, and would help me manage my pain. So I convinced myself that Dr. Don gave me just what I needed when he prescribed methotrexate and told me to come back in three months. And I convinced myself that sitting in his waiting room for hours every time was the price I needed to pay to get care from “the best.”
He wasn't good at listening to my concerns
But I was wrong, of course. My report of daily morning sickness for months after starting methotrexate had no impact on his approach to treatment. And that just didn’t work for me. I needed a doctor who would listen to me, and who would take my concerns into consideration. The right doctor would partner with me on solutions. Instead, I had a doctor who knew the science but didn’t know the patient.
Breaking up (with my doctor) isn’t so hard to do
In addition, I was wrong about the kind of care a patient should be willing to accept from her doctor. One day, while waiting for hours in Dr. Don’s office yet again, I read an article in one of those magazines that litter every doctor’s lobby. Written by a physician, it was called “Top Ten Signs You Should Find Another Doctor.” The #1 sign? “You have a doctor who routinely keeps you waiting over an hour.” It was my last appointment with Dr. Don.
Beware the soap opera doctor
Another time, a coworker introduced me to Dr. McSeamy*. Handsome and charismatic, McSeamy talked about partnership and asked questions to get to know me. He had diplomas from the best schools. He wanted me to feel well, not settling for not-so-sick. So I agreed to stop medications that had been working well and start something else, despite its black box warning. And that's when my dreams of feeling well became a nightmare.
If it seems wrong, it probably is
The new drug wasn’t managing my symptoms at all. McSeamy said to give it time. At the next appointment, I was still no better. I suggested going back to the old drug. But he wanted to keep trying. And then my feet began to swell, so badly that the skin felt tight and I could wear only slippers. Frightened, I scheduled an emergency appointment. McSeamy looked annoyed when I explained the relentless edema, and downright angry when I suggested it might be from the drug. He refused to accept the possibility.
Trust your gut
So on a hunch, I asked him whether he receives compensation from any drug companies. His anger turned to rage. He wouldn’t answer my question. Instead, he told me to see my primary and get some Lasix for the swelling. I walked out and never returned. Within a year, the FDA removed the drug from the market. I also discovered that McSeamy earned six-figures a year from the manufacturer of the now-banned drug.
A good rheumatologist is hard to find but keep trying
I finally found Dr. Steve by taking stock of my needs: collaboration, accessibility, transparency. Most importantly, I wanted a doctor who respected my intelligence and calmed my fears. I interviewed many candidates to find THE ONE, and he landed the job easily. (I live in a big city, where I am fortunate to have options. In some areas, choices may be more limited, but it’s worth the effort to find the right doctor, even if it involves some travel. For helpful guidance on taking stock of your needs, see rheumatoidarthritis.net/living/finding-the-right-doctor.
My key lesson: it was never about finding THE BEST doctor in the city. It was about finding the right doctor for me. And that’s something only I could find out. (McSeamy and Dr. Don both still practice here, and they are great for many patients. Just not me.)
My advice? Don’t be afraid to ask questions or to research the doctor’s practice. Don’t feel you have to accept a doctor who isn’t a fit for you just because you’ve been going there for years or someone you trust referred him/her. The most critical relationship a person with RA makes is with his/her rheumatologist. Make sure your relationship is a love story, too.
And thanks, Dr. Steve. To borrow from Effie in Dreamgirls, “You’re the perfect doc for me. I love you, I do.”
Has menopause impacted your RA?