Kicking Your Doctor to the Curb | Arthritis Information

Since I've been less than happy with my RD in some respects it got me to thinking about whether or not I should move on to a different one. The thing is, it's not a black and white issue as it is with SOB ENT doctor I saw. He's just a jerk. However, my RD is good is some ways and too casual in others. For instance, he never ordered a baseline exam for my eyes before the Plaquenil and no baseline X-Ray for the MTX. And I had to remind him to give me a scrip for the 6 month follow up the eye exam. If I didn't know about these things, I wonder how long it would take before I would suffer adverse consequences due to his treatment or lack thereof. When I read things others have been told by their RDs that could also apply to me, I wonder why he never told me those things....like it's OK to spread the MTX out over the day. When I asked him he said it's OK, but why did I have to ask him first? I mean, he's quite uncommunicative, yet I think he's giving me good treatment meds-wise and is trying to do it right.

So my question to you is, have you ever switched RDs? How long were you with the one you left? Why did you leave? How many RDs have you had and over how long a period of time? If you had it to do over, knowing what you know now, would you still leave the first RD?

I don't want to be overly critical of my doctor. No one is perfect. I'm just not sure what's worth leaving for and what's not. The next one could be worse.

Jesse,

I thought of a couple of things while reading your post. One, my Dr. wasn't going to require a baseline eye exam when he wanted to put me on Plaquenil. I decided not to go that route in the long run. As for the no baseline x-ray for the MTX...did you ever have baseline x-rays? To this day, I have not had baseline x-rays of my feet even though I have pain and I'm sure damage.

What you might take into consideration is that every practicing physician, nurse, etc. do things differently. Just the same as no two people are the same, neither are two doctors. Just because your Dr. didn't tell you that you could spread out your Mtx, doesn't mean he was being neglectful. It is so very important for you to take a proactive approach with your care. My Rd asked me every time I see him if I still want to take my Enbrel twice weekly (25 mg SQ). There is absolutely NO information backing up my "theory", other than it makes me feel better. He is o.k. with that.

There are two things I would urge you to do: Be more proactive in your care. Don't wait for the dr. to tell you what to do or how to do it. Research, go to the apt. with knowledge. When I go to the Rd, I know what I want him to give me and what I don't want to take. Take some responsiblity in your care too!!!

Secondly, find an Rd you like. If you don't like or trust your Rd, find one you do. This is a very important relationship and you must have someone on board you want and trust.

Good Luck

Phats

baseline for MTX is not a mandatory thing especially with newer scripts. The lung issues are rare enough that unless there is some compelling reason the x'ray isn't all that important. Most people don't require prescriptions or referrals to see an eye doctor so to me reminding your doctor that you do is not out of line. We cannot expect our doctors to know the requirements for our insurance plans.

It sounds like you have a good doctor that you don't communicate well with. If you like the doctor work on changing that communication. It takes two..so like Phats said it may require you to ask more questions, even if you know the answers already it helps to get a conversation going. Talk to him about your communication issues. He may not know you are uncomfortable unless you broach the subject. Remember school...the teacher assumes we know and understand unless we ask for clarifications.

By all means, though, get a second opinion, but also be upfront at that appt about what you expect from him. Make sure you are on the same page from day 1

Jesse, I always go to the rheumatologist with my pain/symptom chart and a list of questions and issues to discuss. Otherwise I forget what I want to talk about. She sees dozens of people every week, plus she's got a husband and kids to keep track of as well. I can't expect her to remember every detail, especially when I only see her 3 or 4 times per year. oh I forgot to answer the other questions. I have actually changed doctors several times through the years. I'm on my 7th in the 23 years since diagnosis. However for most of them I have changed because I moved. The last several changes have been because my doctors have moved. I changed to other doctors in the practice which is the best in the city. Only one, my second rheumatologist, I would not go back to..he missed the beginning of my 3 year flare from hell. That was the only time I let my insurance dictate who I saw. I learned my lesson and will and have paid out of pocket to get someone I preferred. My favorite all time doctor moved to Pittsburgh (booo!!!) if I hadn't liked his partner I would have been driving there every 2 months buckeye2008-02-19 16:31:44OK, this is good information. Maybe I'm being too critical. I have to say though, that it is through research that I learned about the lung X-ray being important, and my optholmogist said I should have been told to get a baseline eye exam and everything I've read said two exams per year are very important. If he had EVER mentioned the eye exams to me at all, I would happily run with it take the responsibility from there on. I am, after all, a big girl. But there was no mention of it at all. I talked to the eye doctor who did my lasik when I read about the need for these exams and he said yes, it's important. The lung exam, well, that I can let pass if others don't get it , but it seemed like many did, when I posted that question here.

The biggest problem is, in fact, communication. I have my list of questions each time, but he's got one hand on the door after what he thinks is my alloted time and I usually don't get past my second question. Once I told him "I'm not done yet" and he sat back down, but I don't want to be doing that every time. I guess, I have no choice here. I either have to be more pushy is getting my questions answered, though it makes me uncomfortable, or I have to find an RD who welcomes questions, within reason of course. I can't expect a doctor to sit through 10 questions or more, but I do need more time than I'm getting. That's the whole point, I guess. I do a lot of research, which makes me have questions, but I'm too timid to push for the answers I need. I guess I just have to weigh his good points against his bad ones and decide which I can live with and which I can't. Like I said before, no one doctor will be perfect.