Living with Psoriatic Arthritis (PsA)

I fired my doc


and it is one of the best decisions that I have made. Many posts have referenced changing Rheumatologists or wishing they had. I decided to find a new one around the Christmas holidays. Why did I do this? My former doc was a nice guy, was good about keeping my medicines under control and issuing refills promptly. Everything was fine as long as no new issue or problem arose. Over time, I came to realize that he liked the "20 minute " patient. He wanted patients that he could see for a max of 20 minutes and then move on to the next one. Too much of his time was a problem and I was being rushed, albeit in a very friendly manner. When my Remicade infusion ceased to be effective, he really dragged his feet getting a replacement. I admit to demanding he find something that Medicare would cover. I was being seen every 3-4 months and we were not making much progress. The final straw was his response to my knee problems. Arthritis had left me with bone on bone findings in both knees. I had been seeing an orthopedic doctor and had taken shots (Euflexa) into my knee joints, as a way to avoid knee replacement surgeries. These “gel shots” had been very effective for me. I made it a point to advise him when I got these shots so that he was current with me and my arthritis. I had an appointment with him and I mentioned these shots while there. His response was “why don’t you go ahead and get the surgery. You know you will eventually need it, and you are just wasting insurance money to put it off.” There were a number of reasons not to have surgery unless absolutely necessary which he and I had discussed previously. I remember thinking that he had not listened to a damn thing I had discussed with him over nearly 3 years. Then I remembered he had never done anything except see me in the office. He had not even had a single x-ray taken. I decided right then that the time was now to make a change.

I got a referral from my ortho doc to another Rheumatologist. For some reason, our area has a shortage of Rheumatologists, so I didn’t know if the new doc would take me or not. I completed all of the paperwork associated with a new patient, including my medical history for the 24 years I had been treated for psoriatic arthritis. The first thing she said to me was “wow, you’ve really been through it and I’m so sorry.” I initial thought was here was a doctor who had actually taken the time to read about my medical history, and who had compassion for what I had gone through. I think many of you who have had similar frustrations with doctors, as well as battling this disease for years, can appreciate it when I felt I had definitely made the right choice when I changed doctors. She’s been great so far, and the difference in attitudes is phenomenal.

So, I guess what I am trying to say is don’t be afraid to make a change. As in any field, there are good and bad; and doctors are no exception. Don’t lose sight of who the patient is, and who the medical professional is supposed to be helping. Maybe those of you thinking about making a change will get some benefit from my experience.


Congrats on switching! It sounds like it was a good move for you. I also fired my first Rheumy even though I was grateful to him for giving me a diagnosis after over a decade of misdiagnoses. I had to drop him when he refused to listen to my concerns about medication side effects, told me to ignore black box warnings, and essentially called my father an idiot. I have to travel a lot further now, but my new Rheumy listens to my concerns and answers all of my questions.

On a side note, my first Rheumy was actually my second Rheumy because I went to one years ago by accident (insurance co had him listed as a GP) and he was also a jerk who didn’t want to listen. There aren’t many rheumatologists in my area, either. I’m not sure of the significance but it seems like there are very few Rheumy in general and a disproportionate number of the them are jerks. Maybe someone on here knows the reason(s) for this.

1 Like

After 8 years I am also looking for a replacement. My primary doc finally referred me to Ohio State. I will be seen on May 14th and hope I can finally get this horrible disease under control.
I seriously worry that I’m going to die from all of the infections I have been getting since I was switched to Semponi lat May. It hasn’t helped except to really lower my immune system. I was very ill starting in July to October with ear infection and URI. And have had 3 ear infections since with a current URI. So hoping for the best for both of us.

1 Like

I think it’s the same all over: shortages and clock watchers. But think of it. Until fairly recently, most of a rheum’s practice consisted of incurable people, all in pain. Every day. I think that’s changing, though.
Here’s a blog I wrote a while back

1 Like

Schoonerbird, right on! It’s not easy to do a change, but everything you’ve said is correct in my book, and I couldn’t have said it better myself. Sometimes you just have to change docs in order to move forward.

I’ve had the best luck when I’ve asked one specialist who knows me well to refer me to another specialty, rather than going through the GP. I don’t know whether others have experienced the same.

Your new rheum sounds like a keeper! Well done. It will be interesting to see how she manages your PsA.

1 Like

A couple of years back I changed my Rheumatologist because he moved to another location and it was too far for me to travel there. He was replaced by another Rheumy that he recommended. This Rheumy was so dismissive and kept on telling me “its all good and it is just Osteo Arthritis” he did not acknowledge the PsA that I had been diagnosed with after having sausage toes which is one of the symptoms for PsA not Osteo. I found myself sort of arguing with this Rheumatologist so I changed my Rheumatologist and even though my visits are short with this Rheumy as well, I am not being dismissed and I feel comfortable and he is pleasant and attentive with me.
What I realized was after the initial visit all other visits were for 15 minutes and the treatments follow the same processes…My visit with the Rheumy consist of a question on how I am doing - which mostly did not seem to change anything. The Rheumy would look at my blood tests results, print out a new prescription and hand me a new form for the next blood test, I would ask him any questions. None of which made any difference, but some satisfaction in sometimes getting an answer. I came to the conclusion, if my PsA is under the best control - it is as good as it gets. If things were not going well then my meds/injection are changed.
In between visits now every six months I rely on the internet and this site for answers. I am now on my third Rheumy and short appointments have been the norm for me. I do think it has something to do with how Medicare works in Australia. Perhaps it is the amount of the Medicare payments to the Rheumatologist is why they keep there visits short. I keep questions, short and to the point as I am so aware of the doctors time and all the other patients that are sitting in the waiting room. I use to get so frustrated with not having enough time to get all my questions answered but over time I accepted the system for what it is and I cope better now that I know as much as I do. Sometimes there are no answers and having to accept that is not always easy. I hope my short visits let you know this is how it might be with the new Rheumy. I do hope your new Rheumatologist is better for you than the last one…

1 Like
split this topic #7

7 posts were split to a new topic: Biologics and medicare