What To Do When Your Rheumatologist Leaves or Retires
Time is of the essence.
Your local hospital announced that it’s closing its rheumatology clinic.
Your stomach churned when you opened the letter from your long-time rheumatologist announcing his retirement.
For many people, having to find a new doctor is just an inconvenience.
For people with RA and other autoimmune conditions, it’s an emergency.
Even patients whose disease is stable are at risk. People with autoimmune conditions need timely labs to monitor treatment. They need experienced physicians willing to renew prescriptions so treatment isn’t interrupted. And they need prompt access to expert care to manage flare-ups or new symptoms.
Meanwhile, patients flood the remaining local rheumatologists with appointment requests and it gets harder and harder to find someone locally who can see you quickly.
Many practices can’t take new patients. Others have as much as a six-month delay before your first appointment.
These serious conditions require active medical care. With prompt diagnosis and treatment, they’re very manageable. Without it, they’re life-threatening and often cause irreversible damage.
Strategies to Continue Your Medical Care
You have lab results but not a final diagnosis
- Positive ANA, positive rheumatoid factor, high uric acid levels and other labs may or may not mean that you have an autoimmune disease.
- It’s important to find out quickly what your diagnosis is to avoid permanent organ damage.
- Ask your primary care physician if they’re comfortable obtaining and interpreting the necessary labs and completing the autoimmune workup rather than referring you to rheumatology.
- We frequently work with telehealth patients in our Arizona, California, Florida, Indiana, Kentucky, Montana, Ohio and Texas service area to complete your diagnostic workup and rapidly establish your treatment plan. We’re happy to help you transition to your local specialist once an appointment is available.
You recently got an autoimmune diagnosis
- Giant-cell arteritis (temporal arthritis), ANCA vasculitis (granulomatosis with polyangiitis, EGPA or Wegener’s disease), lupus and certain other autoimmune conditions can become rapidly life-threatening if not quickly and appropriately treated.
- Your family doctor will likely refer you to a local rheumatologist, because these serious orphan diseases and their treatment usually exceed the experience of most primary care physicians.
- If you’re going to have wait months to actually see the rheumatologist and you’re in our treatment area, please contact us. Our practice is designed for ease of access and rapid appointment availability. These are very serious conditions and it’s essential that you quickly establish appropriate treatment.
- Dr. Girnita provides expert diagnosis and advanced treatment of rheumatic and autoimmune conditions in Rheumatologist OnCall’s 8-state service area. She’s very comfortable working with you to establish treatment until your local rheumatologist is available.
Your autoimmune disease is stable
- Patients with stable rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis or gout and an established treatment plan may be able to temporarily transition care to their primary care provider.
- Ask your regular family doctor or internist if they can help monitor your symptoms until you’re established with a new rheumatologist
- If they’re not comfortable, or lack appointment availability in their practice, contact us for an immediate appointment.
You need regular labs to monitor meds
- If possible, ask your current rheumatologist to place standing (recurring) lab orders for a year’s worth of labs.
- If your rheumatologist is unavailable, ask your primary care doctor if they can do this.
- Confirm that they’re comfortable monitoring these lab results—many primary care physicians aren’t.
- If not, our contract with a national clinical laboratory allows Dr. Girnita to order low-cost lab tests throughout our eight-state treatment area. She can interpret your results and adjust treatment as needed.
You need prior authorization for injectable or expensive meds
- Check the date on your prior authorization. If it expires soon, ask your current rheumatologist to go ahead and renew it if possible.
- Dr. Girnita can start, renew, or modify your prescriptions and help you get prior authorization approvals if you’re in Arizona, California, Florida, Indiana, Kentucky, Montana, Ohio or Texas.
- We can also help you locate low-cost sources for your medications.
Your meds are running low
- Ask your current rheumatologist to place refill orders for at least 90 days.
- Ask your primary care doctor if they’re comfortable refilling essential autoimmune medications like methotrexate, Plaquenil, sulfasalazine or Arava (leflunomide) until you’re established with a telehealth or local rheumatologist.
- Call your insurance company and ask them to approve a 90-day supply of meds while you look for another rheumatologist.
- If you’re in Arizona, California, Florida, Indiana, Kentucky, Montana, Ohio or Texas, Dr. Girnita can start, renew or modify your prescriptions and help you locate low-cost pharmacies in your area.
You're worried about RA or gout flare-ups
- Ask your current rheumatologist to send a tapered prednisone prescription to your pharmacy and give you instructions for its use, so you’re prepared if a flare occurs.
- If you do experience a flare-up, tell your primary care physician about it. Are they comfortable managing it?
- If flare-ups are increasing or getting worse, don’t delay treatment adjustments while you search for a new specialist.
- You can always see us virtually (or in-person if you’re in California) for immediate treatment evaluation and transition to a local provider once you find one.
