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#1 Clementine

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Posted 26 July 2007 - 04:30 AM

Hello,
I still do not have a primary care physician. Do you all think it is better to see an Internal Medicinist over a Family Practice Dr when you have systemic sclerosis?
I found a DR. I want to see, but she's a Family Practice Dr. and I've had it in my head to go to an Internal Medicinist.
Thanks,
Jen

#2 Shelley Ensz

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Posted 26 July 2007 - 05:03 AM

Hi Jennifer,

That's a good question. I believe the general recommendation is that people with systemic sclerosis should have an Internist as their primary care practitioner.

But there are some very sharp and personable family practice doctors who are worth their weight in gold. Why don't you set up an initial interview with the doctor, to see if it is a good fit for both of you?

Most doctors will do such appointments for free (ask about this when you are booking the appointment); usually they are 10 minutes, sometimes more. Do your homework first, and bring a list of questions - one of them being, do they have any familiarity with scleroderma, if not are they willing to learn more about it, and would they be comfortable taking on a complicated medical case and coordinating care with your team of specialists?

A few doctors are eager to take on challenging cases, while many others really do prefer just dealing with the basics and are a fish out of water trying to handle scleroderma, which would be very frustrating for both of you. So listen closely to their responses and their attitude, and make your best decision.
Warm Hugs,

Shelley Ensz
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Hotline and Donations: 1-800-564-7099

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#3 Nelly

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Posted 26 July 2007 - 05:33 AM

Just to add to what Shelley said.....you might want to ask how often or when the family doctor refers you to a specialist. I see a Family doctor, and so far he has been wonderful. He jumped right on my symptoms and had me seeing a rheumatologist right away. Later that year when I started have frequent UTIs (which also showed blood and protein in my urine) he immediately referred me to the appopriate specialists. I think the key to him is that he knows his limitations and is willing to say this is out of my league when he suspects something going on other than the normal everyday patient stuff. If he wasn't like this, then I would seek out an internist.

Good luck!

#4 jefa

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Posted 28 July 2007 - 02:02 AM

Hi, Jen. Let me add my tuppence to the existing excellent advice. I don't think the type of doctor makes as much difference as the personal characteristics. These days virtually all doctors have a computer sitting on their desks with access to any and all information as each other. The key is getting one who will listen carefully to your questions then respond specifically to what you have asked. In order to get this care, you need someone who is willing to spend a little more effort and time with you. As part of the British National Health System, I am required to have a primary care physician who specialises in General Practice as my point person. All referrals come through him (or her as the case has been) and we may not contact a specialist directly. But I believe this is a good idea if you have a good primary care physician. Here is one person who is aware of my total health situation and can run interference with the more limited though specific instructions of the specialists. In our case, the specialists don't usually actually write prescriptions (except in the case of things administered at their own clinics, like methotrexate, etc.), but instruct the primary care physician to do so. The specialists tend to give a lot of credence to the letters written by the primary care physician and vice versa. It has taken me four years to 'train' my primary care physician and I consider him my best ally. He now routinely allocates me to his long appointment days and I have moved to top of the list with first appointment of the day. I never feel rushed with him.
Warm wishes,
Jefa

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#5 LisaBulman

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Posted 28 July 2007 - 02:37 AM

Hi Jennifer,
I'll jump in too! Way beack when I had a primary dr that I never went to. It was in a medical building and I was on an HMO. That dr left the practice and I was assigned a new dr in the building. It didn't matter to me because I never went. Well when I had a really bad attack with raynaud's where my fingers were blue for weeks, I decided to go. I met my new dr, who was wonderful, diagnosed me with raynaud's on the spot and did a ton of blood work. I went back in two weeks later for the results and at that time he told me I may develop sclero and lupus, or one or neither but my blood was indicating this. Well come to find out, he is a internist but with a strong background in rheumatology! He was the best accident that ever happened to me. He has since moved his office twice and I have followed him. I am still in a managed care plan and he gives me referrals whenever I need them. I don't even have to go in, I just send off an email and the medical secretary says, "Sure Lisa, all set". Maybe you'll hit the jackpot with a dr like this too.

Hugs,
Lisa
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#6 Clementine

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Posted 28 July 2007 - 03:33 AM

Thanks everyone! I made an appointment with a family practitioner that is female. She was recommended to me by my best friend and several of her coworkers go to her.
I have been fortunate that my rheumatologist has been the one to refer me to all the specialists. The hospital where my rheumatologist practices is a hospital that specializes in respiratory diseases, so I feel I did hit the jackpot with him! They coordinate everything for me and get me into the specialists without too long of a wait.

Thanks everyone. If it's a bad appointment you'll be hearing from me. Remember, I was the one who ran out of the office with the last primary care physician I saw.
Thanks,
Jennifer

#7 Sweet

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Posted 31 July 2007 - 02:18 PM

I think it really depends on the doctor. Good rapport is critical, in addition to the doctor being willing to understand what is going on with you and having knowledge about the disease. I would check them both out and then pick the one you like the best.

My primary care physician is a family practice doctor and he's brilliant with auto immune diseases. He caught what was wrong with me on my first visit to him.
Warm and gentle hugs,

Pamela
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International Scleroderma Network (ISN)

#8 WestCoast1

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Posted 31 July 2007 - 03:51 PM

HI Jen,
I was just wondering how the primary care physician appointment went? I have seen mine once in the last year and she has admited to knowing nothing about autoimmune illnesses. My rheumatologist says that I have to stay regular with her for general purpose needs. In fact I have an apt. with her next week.
*WestCoast*

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#9 Clementine

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Posted 01 August 2007 - 03:57 AM

Erin,
My primary care physician appointment is Friday. I will let you know how it goes. I think it will go well since she was referred to me by several women. As long as she's willing to learn about my condition. I am also bringing my last set of doctors notes which tells all my medical woes.
xo
Jennifer