Getting a Referral and Diagnosis

A rheumatologist is a doctor who specializes in treating arthritis. When living with the symptoms of inflammatory arthritis (most commonly, rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis), a rheumatologist can be a patient's best resource. These specialists have at least five years of additional training, on top of their regular medical schooling, in diagnosing and treating arthritis.

It can be incredibly challenging to get a referral from a general practitioner to a rheumatologist. This may be because there are so many forms of arthritis, and general practitioners may not be familiar with many of the symptoms of the more than 100 different types of arthritis. As well, symptoms can mimic those of many other different types of disease, so arthritis may not be the first thing a general practitioner thinks of when presented with a less common form of arthritis.

Another problem which may make it challenging to get a referral to a rheumatologist is that there are simply not enough rheumatologists in Canada to care for all of the people living with some form of arthritis. Currently, there are less than 270 rheumatologists practicing in Canada. When you consider that more than 4,500,000 people, in this country are living with arthritis, it becomes clear that there are simply not enough rheumatologists to treat all of the people who need treatment.

While this may seem discouraging, there are some things you can do to better your chances of getting a referral to a rheumatologist.

First, tell your doctor if you have the hallmark symptoms of inflammatory arthritis. These are:
  • Ongoing joint pain and swelling
  • Ongoing morning stiffness, lasting more than an hour after rising
  • Inability to continue daily work and living activities.

Also, tell your doctor about any history of inflammatory arthritis in your family, as some forms if the disease may have a genetic component.

Once your general practitioner suspects inflammatory arthritis, he or she will need to write you a referral letter. This letter should include the following:
  • The suspected diagnosis of inflammatory arthritis.
  • A brief history and clinical findings. These may include morning stiffness, weight changes, fever patterns, and number and types of joints affected.
  • Copies of all reports, including MRIs, x-rays, and letters from any other specialists consulted.

Studies show that people with inflammatory arthritis diagnosed by a rheumatologist do better. They are diagnosed more quickly and treated more appropriately, and appropriate treatment can prevent joint damage, decrease pain and swelling, and decrease the possibility of permanent disability.

If you are having difficulties getting a referral, be persistent. Remember that the people who end up getting the health care they need and deserve are often those who have refused to take "no" for an answer.