A doctor-patient relationship is a lifelong relationship for someone with chronic arthritis.
Since the illness is chronic, and without a cure, regular appointments are scheduled with your doctor to diagnose and problem-solve. It's a process and a journey you take together with your doctor. It is imperative that your needs are being met. Consider these 6 C's:
Communication
It is clear that if you and your doctor are going to problem-solve and work towards achieving quality of life for you within the framework of your chronic illness, you must be able to communicate with each other.
- There must be an ease and comfort when you talk.
- The doctor must be willing to listen to your concerns, be open to all of your questions and be candid, yet caring with his/her responses.
- The rapport you have established must be completely based on trust.
You must trust you will be heard, trust that his/her decisions are sound, and trust your options will be fully explained to you.
Cost
The financial impact of chronic illness can approach exhorbitant, so cost needs to be a factor.
- Does your doctor make it easier for you by allowing you to pay co-pays by credit card?
- Does your doctor offer you free samples of medications whenever appropriate?
Obviously, your specific health insurance should be congruent with your choice of doctor. Health insurance coverage can make it a more narrow field from which you can choose your doctor.
- Is the doctor you are seeing part of the HMO (Health Maintenance Organization) you belong to?
- Does your doctor accept Medicare assignment or Medicaid?
- Is your doctor on a preferred-provider list which is offered by your place of employment?
Convenience
Ideally, the location of your doctor's office should be convenient. Having to travel far for frequent appointments can be aggravating.
- Is the time you spend in the waiting room within what you consider reasonable limits?
A longer-than-acceptable wait is understandable when it occurs rarely, but if it is the norm or if the entire office operation seems chaotic, that is not the convenient situation which a patient needs. Consider also:
- How long it takes to get an appointment
- Can you easily get prescription refills called in?
- Can you easily get a phone message to your doctor and does your doctor respond in a timely fashion?
- Is your doctor affiliated with the hospital of your choice if you were to require hospitalization?
Continuity of care
Continuity of care is important.
- If you have multiple health problems or comorbid conditions, is your doctor diversified enough to handle the entire situation?
- If your doctor specializes, does he have a good team of associate doctors?
- Can you be assured that there will be continuity of care even if other doctors are called upon?
Doctors must share their diagnoses and treatment plans so the whole patient is being treated. Your primary doctor must take charge and coordinate, so that continuity of care is achieved.
Confidence
There is no other way to say it - your doctor must exude confidence and be conversant, having knowledge and experience.
- Your doctor must leave you feeling that your health matters are under control.
- You must have confidence in what your doctor says today and in what your doctor expects will happen tomorrow.
The confidence you have in your doctor is directly proportional to how compliant you will be with your treatment plan.
Contemporary / Cutting Edge
Your doctor should be knowledgeable about the latest treatment options. Have you considered seeing a rheumatologist? Exciting new arthritis medications have become available in the last decade. It is critical to have an arthritis specialist who knows about the newer classes of drugs and recognizes their possible side effects. There are now over a 100 drugs used in the treatment of arthritis and related conditions.
Arthritis drug options now include:
- NSAIDs (non-steroidal anti-inflammatory drugs)
- COX-2 Selective Inhibitors
- DMARDs (disease-modifying anti-rheumatic drugs)
- Corticosteroids (glucocorticoids)
- Painkillers (analgesics)
- BRMs (biologic response modifiers)
- Topical medications (creams, gels, etc.)
- Other medications, including drugs used to treat fibromyalgia, gout, Sjogren's syndrome, and osteoporosis
Your doctor must not be complacent with older treatments, but needs to be aggressive and see the wisdom in trying the new cutting edge drugs, when the patient is an appropriate candidate.
Should You Change Doctors? / Are Your Needs Being Met?
Assess the issues in your own care such as:
- communication
- cost
- convenience
- continuity of care
- confidence
- cutting edge
Don't settle for less than an optimal situation.
