Physician Rheumatologist

Training

• Medical School (four years)
• Internal Medicine Residency (three years)
• Rheumatology Fellowship (two to three years)

License/Certification

American Board of Internal Medicine Rheumatology Certification Exam

General Description

The rheumatologist is a specialized internist who helps with all aspects of patient care, including: 1) making diagnoses, 2) providing recommendations and prescriptions for treatment, 3) medication management, and 4) coordination of patient care. Because rheumatic diseases can be complicated and may involve multiple organ systems, the rheumatologist commonly shares patients with other specialists. The rheumatologist can also refer patients to other rheumatology professionals, including physical therapists, occupational therapists and pharmacists. Rheumatologists are often leaders of a practice and may work in both the inpatient and outpatient settings. Of all rheumatology clinicians, they are generally best suited to manage complex patient cases. Rheumatologists can also engage in clinical, translational or basic research and may oversee a clinical research team or laboratory as a principal investigator.

How/When to Refer

Patients can be referred to a rheumatologist by any healthcare professional who believes they would benefit from specialty care. Rheumatologists may also be recognized as clinical experts within specific disease areas and may receive requests from other rheumatologists to provide second opinions on patient cases.

Case Study

Rose, a single, 50-year-old woman, was diagnosed with rheumatoid arthritis one month ago. She just started methotrexate and prednisone to control inflammation. She reports a one-year history of general pain and swelling in her hands and feet, as well as morning stiffness lasting two hours, extreme fatigue and malaise. She says she often drops things held in her hands, particularly if they are heavy. She is having difficulty getting through her morning routine and getting to work. She does office work and finds it difficult to type, walk or stand for long periods due to pain and fatigue. She has two children in their middle teens.

What Can This Professional Do for Rose?

• Confirm the diagnosis of rheumatoid arthritis, provide additional or alternative diagnoses and consider individual aspects of the diagnosis in relation to Rose’s comorbidities, risk factors and personal circumstances.
• Equip Rose and her family with educational and other resources regarding the diagnosis and her treatment options.
• Monitor medication safety and adjust doses according to Rose’s treatment response.
• Monitor efficacy of the treatment plan and provide alternative recommendations if Rose’s response to therapy fails or is incomplete.
• Place referrals to other rheumatology professionals, including physical and occupational therapists, who can help Rose stay functional in performing her daily activities.
• Provide resources for pain and stress management, and offer corticosteroid injections for joint inflammation when appropriate.
• Offer support for any accommodations required during the course of Rose’s treatment, including completion of Family & Medical Leave Act (FMLA) paperwork.
• Stay up to date on the latest clinical and research advances within the field of rheumatoid arthritis that could benefit Rose during the course of the patient-physician relationship.

 

Updated July 2024