There is a national shortage of rheumatologists.

@cliffg26 - I think rheumatologist aren't alone in the national shortage although for us in the older folks generation they are probably the most important. Here are a couple of articles that might explain some of your questions.

--- American College of Rheumatology Raises Varied Healthcare Provider Concerns in Bevy of Comment Letters to Policymakers: https://rheumatology.org/press-releases/american-college-of-rheumatology-raises-varied-healthcare-provider-concerns-in-bevy-of-comment-letters-to-policymakers
--- Growing Shortage of Rheumatologists “Very Concerning”: https://www.arthritis.org/news/growing-shortage-rheumatologists-arthritis-special

I think we can help by being our own advocate and learning as much as we can about our health conditions and what changes we can make that might help us with a better quality of life. Maybe we can help educate our primary care docs 🙃on what ails us?

Is Mayo Clinics close to where you live? Have you considered a University Medical Center in the state where you live? I went to the University Hospital in my state and there didn't seem to be a shortage of rheumatologists. I live in a rural state so statewide there is a shortage.

I remember when I was first diagnosed with PMR ... that was 18 years ago. I saw a primary care provider (PCP) first but I was quickly referred to a rheumatologist. Sometimes a PCP doctor referring you to a rheumatologist carries additional weight than a self referral. If your PCP thinks your PMR is serious you might be seen by a rheumatologist sooner. Even so, expect to wait 3 months or longer to be seen.

I have seen so many rheumatologists over the years. I didn't ever "doctor shop" and I never requested a second opinion. I saw three rheumatologists when I was first diagnosed with PMR. I was self medicating and treating myself until a PCP informed me that I had a "serious problem."

I still can recall the look of disbelief when I told a PCP that the only thing I wanted from her was a prescription for prednisone. I had to explain why I was taking prednisone that was legitimately prescribed by my ophthalmologist for recurring uveitis. I went on to describe all the pain prednisone relieved even when uveitis was in remission.

The PCP wrote a prednisone prescription for a few days but insisted that I see a rheumatologist.

A University Hospital has teaching as a mission. You will likely see doctors who are being trained as a rheumatology specialist but are supervised by an experienced rheumatologist. My visits involved extra time for training. I usually saw two doctors who were interested in me and rheumatology.

Amen, into my 14 week of the weaning process and not been contacted about a rheumatologist appointment at Traverse City. Near 2 hours away.
Sad you either get better or die before you see one...another profession hit in this perfect society and perfection of a better health care system. ... we overburdened a broken profession. WHY??

There is a shortage of doctors everywhere. Rheumatology is one of the hardest hit. I was referred by my PCP to one of the few(3)in our area which is heavy with medical universities and medical professionals. I saw him within a week because she called a connection she had with his office staff.
I am not impressed with him at all. I think he is absolutely bored with his specialty and actually hates what he is doing.
(On a side note, He also did not attend a quality medical school. He went to one of those “fall back” schools when a person doesn’t get admitted anywhere else).
Today I see my PCP and will ask for a referral to one of the rheumatology clinics hosted by one of the medical schools in the area. It may take until summer to get an appointment but I know it will be better than this doctor.

"Have you considered a University Medical Center in the state where you live might be a solution?"

That may be a solution for me. There is a university medical school about six hours away, but I'm too tired to go by myself. Luckily my wife can usually help, but that turns it into a major trip. I'll make a few phone calls and thanks for the help.

I can't understand the reasoning of the people in charge.

Wow ... six hours is a long way to go. I live about 4 hours from Mayo Clinics in Rochester, MN and I thought that was too far. It doesn't have to be in your own state. It can be at a University Hospital in a nearby state.

Start with your primary care provider and ask for a referral. Your care at a University Hospital can be for a one time consult. The University rheumatologist can then get you hooked up with a rheumatolgist closer to where you live. Otherwise, the University rheumatologist and your primary care doctor can consult with each other.

A PCP can manage PMR with back-up from a rheumatologist. A PCP often manages PMR alone but it depends on how complicated your treatment gets. I'm currently on a biologic medication to treat PMR. My PCP says the biologic medication is "out of his league."

It is important that you like your doctor. I didn't like the first rheumatologist I saw. I don't think she liked me either because she documented in her notes that I was "non-compliant."

I think my first rheumatologist gave up on me. At one of my followup visits, I was seen by a different rheumatologist even though I didn't request a different one.

Anyway ... my second rheumatologist became my friend and managed my care for 12 years until I retired. It was financially better for me to go to a VA hospital across the street from the University Hospital. My long time rheumatologist said she knew every rheumatologist who went to VA. She assured me I would get good care at the VA.

Sure enough ... the first rheumatologist I saw at the VA said he knew all about me. I had never seen this rhematologist before and had just introduced myself.

This new rheumatologist at the VA said I was "too young" and "too healthy" to take prednisone for the rest of my life. I thought he had confused me for someone else at first! However, at this first visit the VA rheumatologist asked me if I would be willing to try Actemra if he could get it approved for me. He said it might be my best chance of ever getting off prednisone.

I was off prednisone a year later.

As I have commented before, my PCP has handled my PMR from the beginning last January. I live within 2 hrs of Duke and UNC but rheumatologists are in short supply and a 3 month wait was not acceptable to doc. Plus, in his experience as an internist they are reluctant to try new approaches such as Kevzara. He handled getting this Tier 5 drug for me thru TriCare for Life(I am retired military) and he anticipates that I will be off prednisone entirely next month. John, our mentor is right about us taking charge of our health care along with our doc.

Do you receive care at a military hospital, the VA or does TriCare allow you to go to any doctor or hospital?

I will be in Florida in January. The VA hospital where I live contacted the Orlando VA to make arrangements for my monthly Actemra infusion in January. It seemed somewhat bureaucratic but the Orlando VA said they can't administer my infusion unless I'm seen by a rheumatologist at the Orlando VA.

It has been arranged so I can have a virtual visit by the Director of Rheumatology at the Orlando, VA Hospital a couple of days before my January Actemra infusion. I'm impressed by the communication done on my behalf. At first they said the first appointment with a rheumatologist at the Orlando, VA was going to be 4 months out which would have been too late for an infusion this January.