My first Rheumy wasn't very good, but I got a different doc when he left, and he's excellent. Very up to date, and thorough. In our state there aren't many choices, but there is one good practice. It's really OK to even ask for a different doc within the same practice. Most docs aren't bothered by that. Just don't give up the one you have until you line up someone else. Often just a frank talk can clear the air with your current doc if he isn't too egoistic.