Studies have shown that people with rheumatoid arthritis who see a rheumatologist regularly (several times a year) do better than people who visit erratically or not at all. The first step is finding one!

• Your primary care doctor can refer you to a rheumatologist. If you like your doctor and have a good relationship, chances are good you'll get along with the rheumatologist your doctor recommends.
• You may be able to see a rheumatologist directly without a referral; check your insurance plan and its list of providers.
• Ask around: someone you know may have had a good experience and be able to recommend a rheumatologist.
• The American College of Rheumatology (www.rheumatology.org) maintains a national database of members. Go to their web site and click on "Find a Rheumatologist."

In many parts of the country, rheumatologists are in short supply. Even if you feel like the situation with your own rheumatologist could be better, don't stop going. Either try to find a way to work through the problems, or continue your regular visits while you search for a new rheumatologist.

Regular visits to a rheumatologist are your "early warning system" for rheumatoid arthritis. Because this is a long-term disease, it's important to catch any changes early.

What can you expect from regular rheumatologist visits?

• Frequent exams of your joints to look for swelling, changes in strength, or changes in range of motion.
• Periodic X-rays and blood tests to follow active inflammation or joint changes.
• Fill out a questionnaire at least twice a year to document your ability level and any changes. Download the Health Assessment Questionnaire (HAQ) at aramis.stanford.edu or ask your doctor for a copy of the questionnaire.

At least once a year, discuss the "big picture" of your treatment plan with your doctor. This can include:

• A diagnosis of the stage and severity of your rheumatoid arthritis
• An estimation of the yearly progression of your disease so far. While not perfect, this can be used to predict future progression.
• New joint damage that has occurred, if any
• Any changes in your level of functioning
• Referrals or the addition of new treatment team members, if needed. This could include physical or occupational therapists, psychologists, orthopedic surgeons, or other health professionals.

Many times, you may feel like not much at all was done, or nothing has changed. Was the visit a waste of your time, or your rheumatologist's time? Nothing could be further from the truth.

• If no changes to therapy need to be made, chances are good your rheumatoid arthritis is stable and progressing slowly, if at all.
• Regular visits, however brief, build the relationship between you and your rheumatologist. Your case of rheumatoid arthritis is unique, because everyone is affected differently. The more often you go, the better your doctor can understand you as a person, as well as your rheumatoid arthritis and how it affects your life overall.

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