ID doctor as part of Bronchiectasis team?

@wsbme74 Hmm. I would use the old, ugly saying "It depends..."
In my experience, the ID doc is only important if you have an active infection and are using or considering antibiotic therapy - that is their forte.
If you have no infection, it would be more important to know if your pulmonologist has a working relationship with an ID doc. Then, if you get into the situation of considering antibiotic therapy they can be added to the consultation.
When I had an active MAC infection (back in 2018-2019) I started with just pulmonology. After I did not convert for 12 months, I asked about an ID doc and my pulmo said it was "not necessary", but I consulted one, within the same clinic, anyway. He suggested changes in my med routine, which I did. The next time I visited my pulmo, he said "Well, if you have an ID doc you don't need me." Ad he walked out. Wow! The ID doc referred me to another pulmonologist who "played nicely with others" .
Do you have NTM/MAC or Pseudomonas? Are you taking or considering antibiotics?

I agree with Sue. I have bronchiectasis but no active infection and don't have an infectious disease doc. If my cultures had been positive, I would have wanted one.

@sueinmn hi, Sue. As always, thank you for your thoughtful input.
I have had staph and klebsiella infections and seem to have to be on antibiotics 3-4x per year, even with all of the airway clearance, etc. tools being used. My BE is moderate, but the lungs also seem to be a sponge and I have asthma. I mask almost all of the time when out. But, it’s not enough.

The infections cleared with antibiotics. But, if they hadn’t, the pulmonogist it seems was just going to determine that I was “colonized” and essentially out of luck. I am also a staph carrier (as u understand now a lot of people are) so am prone to infections even when my skin gets scratched so I wonder if that’s also a way the staph is entering my lungs. It seems that would be the domain of an ID doctor and a lot of the “official” BE literature speaks to the importance of having a multidisciplinary team. I am aghast that your (former!) pulmonologist didn’t see it that way. However, I have now been turned down twice to see the one and only infectious disease team in my area, so it’s a moot point. And this with referrals and a letter of explanation from my PCP. They don’t see the same merits of this team approach!

@pacathy thank you! I do seem to be picking things up a lot in my cultures and I think my pulmonologist would work with an ID doctor (which I would prefer to have their input). But, as I said above, I have been turned down as essentially being “without merit” as a patient of the only infectious disease practice in Southern Maine! Very frustrating.

@wsbme74 It seems to me that an ID doc would be important in your situation, and I am sorry you have been turned down. Perhaps they don't feel qualified to manage a Bronchiectasis patient? My first suggestion at this point is that you might need to look at a more distant ID doc - can your pulmonologist help you find one? The second would be to consult the list of Bronchiectasis centers and determine if you have access to any of them:
https://connect.mayoclinic.org/discussion/the-bronchiectasis-care-center-network-33-centers/

I agree with Sue about a consult at a bronchiectasis center if possible.
I have a couple other speculative thoughts. One is that if the bugs you grew out were sensitive to antibiotics and you responded first round, that could explain the infectious disease doc's decision-thinking
problem resolved.
If you're picking up frequent infections, perhaps an immunologist could help determine the reason. Your PMD or a Center as Sue suggested could give a better answer about your need for that. As I said...a thought. Good luck.

My Dr at Mayo added the Ifectious Disease Doctor to my care team as MAC is an ifectious disease. I see them both on a regular schedule and they work together to manage my treatment plan. In my opinion it is a win/win

@mamiebarker I, too, have both ID and pulmonary Drs who work as a team-but I will say they don’t always agree! (I have both MAC and BE). When I was on treatment, the ID Drs managed the medications.
When I have BE flare ups, it’s handled by Pulmonologist.

@wsbme74
Hello from southern NH. There is a well respected BE program at Mass General Hospital in Boston. If you don’t mind the drive it may be worth your time. They have a multidisciplinary approach.