Rheumatologist

Definition

A rheumatologist is a physician specialist with additional training in diagnosing and treating arthritis and other joint, muscle, and bone diseases.

Description

The medical field called rheumatology deals with disorders that involve the musculoskeletal system, or the bone and joints, as well as the tissues that connect them. Many of the conditions they treat are autoimmune diseases. They are called this because the person's immune system , which normally helps the body fight disease, instead attacks the body. In the case of rheumatoid arthritis , the immune system attacks the tissues of the joints. In addition to rheumatoid arthritis, rheumatologists treat other diseases such as gout, scleroderma , systemic lupus erythematosus, osteoarthritis, osteoporosis , fibromyalgia , and polymyositis .

Generally, rheumatologists are internal medicine physicians (also called internists) who receive additional training in rheumatic diseases. There are some rheumatologists who specialize in childhood and adolescent rheumatic diseases. In general, the rheumatologist helps patients control the inflammation and pain associated with diseases such as arthritis.

Work settings

Rheumatologists may work in a number of health care settings. Many work in private medical offices. Sometimes, the medical office is a small, private office dedicated to the specialty of rheumatology. Other times, the rheumatologists works as part of a large group of specialist physicians who may help patients with many different types of problems. This is called a multispecialty practice. Some rheumatologists may work in outpatient clinics or on special hospital units. Those who work in hospitals may see patients and also teach rheumatologists who are in training. Some rheumatologists work in rehabilitation or transitional care settings. There are some rheumatologists who may become interested and involved in research. They may work in clinical laboratories, attempting to determine the cause of rheumatic diseases or to identify new treatments.

Care team role

As a specialist, the role of the rheumatologist on a senior's care team may vary. Often, the rheumatologist acts as a consulting physician to the patient's primary care provider. When this occurs, a senior's family practice physician, internist, or geriatric specialist may refer the patient to a rheumatologist if there are signs or a diagnosis of a rheumatic disease. Once a senior has a rheumatic disease, the rheumatologist may manage that part of the senior's care, coordinating other health care team professionals. The rheumatologist also should stay in contact with the senior's primary care physician as needed. Since many rheumatic diseases are chronic, the rheumatologist may work with the senior and his or her primary care physician over a long period of time.

KEY TERMS

Autoimmune —Refers to the condition when the immune system, which usually defends against infection and disease, attacks itself or particular tissues in the body.

Rheumatic —Rheuma was a term first introduced in the first century to describe a substance that flows. It now describes a state of rheumatism, or any condition with inflammation in muscles, joints, and fibrous tissues.

Education/Training

Rheumatologists have many years of education. After receiving a bachelor's degree by completing four years of college, they attend four years of medical school, then three years of education and training in internal medicine. After that, rheumatologists must spend another two to three years in special training for rheumatology. Once this training is complete, the physician must pass an examination to receive board certification. Physicians also have to continue to study in their field of specialty to maintain certification.

Family teaching

The rheumatologist will teach patients and their family members about rheumatic diseases, and how they can prevent or lessen disability from them. Thy also may work with them on how to cope with having a chronic disorder, since some of the diseases can limit a senior's daily activities. For example, osteoarthritis, which is more common in older people, causes damage to joint cartilage. The rheumatologist can help guide the senior and care givers in lifestyle changes to better manage the disease. Rheumatologists may teach patients and their families how to ensure they stick with medication regimens, and how to keep the diseases from taking away to much of the senior's physical function.

Resources

BOOKS

Vern Farewell and D. Gladman. “Rheumatology.” In: Peter Armitage and Theodore Colton, Eds. Encyclopedia of Biostatistics, vol. 7, 2nd ed. West Sussex, England: Wiley, 2005. 4629-4633.

OTHER

The Role of the Rheumatologist in the Management of Rheumatic Disease. http://www.rheumatology.org/arhp/briefing/rheum.asp?aud=pat

What is a Rheumatologist? http://www.rheumatology.org/public/rheumatologist.asp?aud=prs

ORGANIZATIONS

American College of Rheumatology, 1800 Century Place, Suite 250, Atlanta, GA, 30345-4300, (404) 633-3777, (404) 633-1870, http://www.rheumatology.org.

Teresa G. Odle