@stk You said, "...I am currently thinking that I may have to move to get an area where I can get better care (and to where my wife can actually get an appointment with a rheumatologist)."

I say "Look before you leap!" Access to excellent medical care is a concern shared by millions in this country. With the aging population, insurance companies dictating many aspects of care, and fewer young people entering hands-on patient-centric specialties, even in major "medical marketplaces" ready access to care is uncertain. Unfortunately, the highest density of specialists often is in the highest-cost living areas.

Is there a middle path for you? Can you look at a major metro area near you, but within reasonable travel distance, where both of you can find care? Even if it requires the occasional overnight stay in a hotel, it would be cheaper and less disruptive to life than a relocation.