An Open Letter to my Future Rheumatologist


Dear Dr. (insert your name here),

First and foremost, let me tell you that I’d so much rather be shoe shopping than rheumatologist shopping.  To put things in perspective, I’ve never gone shoe shopping and left with 5 vials less blood than I came with.  Rheumatologist shopping…different story.

I’m really frustrated.

I think I’m a pretty good patient.  I like to understand and learn as much as I can about my disease state, what exactly is going on in each joint affected, why certain bloodwork is ordered, how my medications work, different options for treatment etc so I can have informed discussions with you.  I do not believe in blind faith as far as medical care is concerned, especially MY medical care.  

In return, I do ask a few things of you.  I expect you to listen to my medical history, understand my goals, respect my concerns, and work with me to find a mutually agreed upon plan.  Specifically, I am open to resuming methotrexate if you are open to me not resuming it.  I’m not trying to tell you how to do your job or play games.  But I am telling you that I’ve had minimal success on it and I would like for you to look at my medical history, think about it, and see if you can come up with a better idea.  That’s all.  If you think it through and still think you’d like me to try it, sure, I’m game. I do realize that practicing medicine is exactly that: practicing.  

But I do ask that you practice- don’t just give me what you give all your other patients.

I don’t think I’m asking the world here and this is not just about methotrexate, although that is a sticking point with me.  I would just like your time and thoughtfulness before you stick me on any strong medication or other uncomfortable course of treatment that (let’s be honest here) you’ve probably never taken yourself and don’t have firsthand experience of trying to function with the side effects of in your daily life.

Here’s to hoping that the next one of you is better!

7 responses »

  1. Sounds like your rheumy appointment last week didn’t go very well 😦

    I sincerely hope that you’re able to find a good one. Soon.

    • He was very nice and I feel a little guilty not being thrilled with him. But I want someone who’s going to work with me, not just give medicine.

  2. One tends to forget the other side of the table… a printout of this letter is going to be right on my desk from 2moro. It would remind me to look at the other side of table …….
    Though methotrexate remains the anchor drug, there are other effective options including Arava, biologicals as well. We Rheumatologists keep talking about methotrexate coz that’s anti RA agent that we trust the most.
    Why dont U make a concise list of your history, medications, expectations, goals & pass it on Ur Rheumie before Ur visit…..

  3. here, here! I’m gearing up for my first appointment with my new one, but he comes highly recommended from a fellow RA-er, so I’m feeling hopeful. good luck!

  4. Oh dear – sorry the rheumy appointment wasn’t great. I hope the next one is – and I do sympathise; mine has been a frustration too although he’s also very nice … when I see him!

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