Rheumatoid Arthritis: Building a Coordinated Medical Team

Reviewed by Michael W. Smith, MD, February 2006

Living with rheumatoid arthritis (RA) can sometimes feel like a full-time job. It's important to remember that you can't gain control of it all by yourself. It's a complicated condition that can affect your whole life; it needs a coordinated approach.

Luckily, you don't have to do it alone. You can build a "dream team" of professional health care providers who are trained to help you. Creating a coordinated medical team gives you the best chance against rheumatoid arthritis. Who should you look for to be on your team? There are several key players you should turn to.

Your Rheumatologist

A rheumatologist is a medical doctor with specialized training in rheumatology (joint disease). Your rheumatologist is at the center of your RA treatment team.

Visiting your rheumatologist regularly is the best thing you can do to get control of your rheumatoid arthritis. This is the person who will monitor your disease and its progression and make changes to your treatment plan.

Your Primary Care Doctor

You may also see a primary care or "regular" doctor, who will manage any other medical problems you may have. Primary care also includes general check-ups and preventive health maintenance (like mammograms or cholesterol checks).

Your Physical Therapist

Physical therapists are skilled at identifying muscle groups and joints that need improvement. They can assess your level of fitness and ability and design an exercise plan to help you build strength and flexibility where you need it most. Since exercise is key to keeping joints healthy, make sure you don't keep your physical therapist on the sidelines.

Your Occupational Therapist

Occupational therapists help you keep your independence. If rheumatoid arthritis starts to slow you down, or if daily tasks become difficult, a visit with an occupational therapist will probably help. Occupational therapists have a playbook of "work-arounds" to let you continue to live your own way. They can also provide or recommend an arsenal of assistive devices that will smooth out the rough spots in your daily routine.

Your Psychologist, Psychiatrist, or Social Worker

Coping with rheumatoid arthritis is something that can be learned. Many people need extra support with the psychological and emotional challenges it brings. These professionals specialize in the more human and emotional aspects of managing your condition:

• Social workers can help you navigate the health care system; provide counseling during tough times; and help you find community or government resources to help you get the care and support you deserve.
• Psychologists and psychiatrists provide counseling, psychotherapy, or stress management therapy. Psychiatrists can also prescribe medicines, such as antidepressants, if needed.

Your Orthopedic Surgeon

Surgical therapy for rheumatoid arthritis has improved greatly over the past decades. There is a variety of surgical procedures that can help you keep good use of your joints for as long as possible. If you feel like your current treatment isn't working, ask your rheumatologist if surgery is a reasonable option.

What's the Best Way to Get Your Own Medical Team Organized?

Start with your rheumatologist, who probably has a network of contacts with whom you can get in touch.

• Keep records. Don't assume all your team members are communicating or sharing copies of your chart. Recent changes to health care law make it your legal right to receive a copy of your medical record. Ask for it, and carry all your records to your appointments.
• Communicate. Make sure each team member knows about important changes, like recent surgeries, hospitalizations, or major changes in your medicines.
• Keep in touch. Maintain your relationships with the members of your team, by keeping your appointments and taking an interest in your care plan.
• Ask questions. People who take an interest in their care for rheumatoid arthritis stay involved and tend to do better.

Next: The Importance of Exercise

SOURCES: Association of Rheumatology Health Professionals web site: "Building an Interdisciplinary Team." Klippel, J., Primer on the Rheumatic Diseases, 12th edition, Arthritis Foundation, 2001.

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