I have my own theory based on the many comments I have read and from my own experience. Apparently, every GP remembers the day in Med School when they were all told that Prednisone was very toxic and the first thing they should do as Drs is start tapering and taper very aggressively. They make two mistakes from this training; the first is that the initial dosage is usually too small and the second is that they start a downward taper too soon and too fast. On the other hand, you have rheumatologists who understand the initial purpose and goal of Prednisone which is to reduce pain and inflammation to zero! Only when SED and CRP lab tests AND the patient's report of perceived pain indicates that all of the inflammation and pain are gone will they decide to reduce the dosage. Then and only then will they start a tapering schedule but the likelihood will be that the taper schedule will far less aggressive than most GP's would urge. When you understand that the original goal of the Prednisone is to make the pain disappear, why would you be satisfied with anything less than a pain score of 0 or 1? Next, since you will be on Prednisone for 2 years (or more) take out a calculator and compute the total Prednisone taken over those 2 years based on two assumptions. The first is the approach of a GP but you have to include several flares where you have to repeatedly return to a higher dosage because you have tapered too quickly. The second is the the rheumatologist approach which has a higher initial dose and a much slower taper but far fewer flares which actually means lower cumulative totals for Prednisone plus the added advantage of no pain. Remember the very old TV ad about auto repairs that went "you can pay me now or you can pay me later" meaning that when we finally are finished with this horrible disease and this horrible treatment, the total we will take will be about the same so do you want pain or do you want relief?