# Primary Care vs Rheumatologist?



## LaurieJ (Sep 3, 2002)

Hi everyone,Hope you don't mind but I am personally curious about how fibromyalgia sufferers think about which doctors have helped them manage and / or diagnose the disease better.I am reading in one of the journals published for Rheumatologists that there is considerable debate over which type of doctor is best suited to care for patients with FMS.On the one hand, there is strong opinion that only Rheumatologists have the special expertise to first diagnose FM (by eliminating other diseases with similar symptoms) and then managing the ongoing care.On the other hand, is the opinion that primary care docs are best suited because there are not enough rheumatologists around to adequately care for the patients that clearly have autoimmune and / or musculoskeletal diseases and that the "gray" area of FMS can be successfully cared for my PCPs.In reading this debate, I have noticed that the authors have neglected to ask or print what the patient thinks. So I am putting it to you guyso you think primary care or a rheumatologist is your physician of choice for managing your FM? Feel free to give me examples of why you think the way you do!Laurie


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## Feisty (Aug 14, 2000)

Hi Laurie.







Well, I saw a Rheumatologist here in Green Bay about 6 weeks ago. I was so gun-ho to see him since I figured that would be my best bet to get some answers for the FM as well as to rule out other diseases and disorders.The Rheumy "officially" diagnosed me with Fibromyalgia. LOL. I've been "unofficially" diagnosed for the last 20 years, so it came as no surprise. He gave me some samples of Ultracet to try for the pain and sent me home to wait on the blood tests and x-ray results of my hands, etc.Test results came back negative for Sjorgren's and for Rheumatoid Arthritis, but I do have arthritis all over the place as well as just one small point away from full-fledged osteo-arthritis of the spine. He called to discuss the results and that was the last I heard from him! He didn't even try to discuss Fibro treatment plans or anything else. Ditto. In fact, I said to him over the phone....."So, in other words, what I have is good ol' Fibro" and he said, "yes". And that was the end of it. So.........I was not impressed with him, but at least I know now I don't have Sjorgren's. I've had better luck with my GP (family Doctor) and it looks like he is the one who will be seeing me for the Fibro as well as other general ailments.


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## SusanLawton (Dec 23, 2003)

I've seen a rheumatologist exactly twice, and she did absolutely nothing for me other than to confirm what my PCP said - that I had Sjogren's and osteoarthritis. Any physician who is familiar with the trigger points of FM can diagnose the disease, because that is what is required for diagnosis, along with simple bloodwork to eliminate other causes. My PCP did a Lupus Profile, which revealed the Sjogren's antibodies among other things, and when he touched the trigger points I screamed as though I had been burned with a poker. The rheumatologist tested me again for exactly the same things, and offered me no options for treatment outside of Plaquenil, which would have been disastrous for me.I'll stick with my PCP. He knows far more then the supposed expert does, and is willing to view information I collect online and take in to him. Susan


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## M&M (Jan 20, 2002)

I too see a GP. He does a great job of listening to me, and coming up with new ideas to try. I've never been to a Rheumatologist, so I don't know if that would be better or not. But, I really like my GP and am quite happy to just continue seeing him. He actually has a rather large practice of Fibro/CFIDS patients.


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## LaurieJ (Sep 3, 2002)

Thank you for your replies.What I am gathering from the patients perspective is that it is not the type of doctor that cares for us (as far as how specialized he or she is in the medical world) but rather how special of a person he / she is. That is, if the doctor is a good people person, that seems to outweigh how many extra years of training he / she underwent.I think that that is an ego deflator on their end, but if I was a doctor, it sure would make me re-evaluate how I interacted with my patients. It truly suggests that laurels and reputation are pretty useless if it means that they patient isn't satisfied with the character or personality of the caregiver.And you know what? I couldn't agree more...I would much rather have a doctor that may not be as formally trained but good at listening and communicating, then one that is considered the best in the field.Laurie


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## christywisty (Mar 12, 2002)

I saw a rheumatologist once to confirm an unofficial diagnosis from a general practitioner and a chiropractor. There's no use in returning.


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## ShellyMcG (Jul 29, 2002)

I have seen a Rheumatologist who specializes in Fibromyalgia for 17 years. Never saw any other doctor, and did not get the--often sadly heard about---- run around.One thing I believe is important Laurie ----- if you ever have to file for Social Security Disability--which I have--a Rheumatologist looks better on the records.When I told my attorney who my Rheumi was---- he got a big smile on his face.BTW--I won. There are many good doctors out there, and we have to decide for ourselves who can be the most help in our situation.Just one Fibromites opinion.Peace & Luv from Shelly"A hundred years from now it will not matter what my bank account was, the sort of house I lived in or the kind of car I drove. But the world may be a different place because I was important in the life of a child."


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