Causes Of Delayed Treatment
Dr. Mona Marabani
It’s remarkable that even now we are seeing people who have been out in the community with undiagnosed rheumatoid arthritis or ankylosing spondylitis or psoriatic arthritis for months or years. It’s not that unusual to see somebody with aggressive, ongoing arthritis that has been like that for 12 months. I can think of two people in the last fortnight I have seen in that situation.
Dr. Irwin Lim
This is a complicated issue with many areas that can be improved. Firstly, some patients ignore their symptoms, they take a while to get to the GP. At the GP level, the GPs need to be aware of the diseases and to make some sort of a diagnosis to help push the patient along the path of diagnosis and management. Then there is a problem with getting from the GP to the rheumatologist. There is availability factors depending on where you live in Australia. There is delayed appointments; the rheumatologist may be particularly busy. In some cases there is affordability issues because the fee might be too expensive. So there are all these steps along this path which are contributing to the delay in diagnosis and management.
Dr. Mona Marabani
If you are not getting better very quickly then I think it’s important for you to ask for a referral and I think most GPs these days are not offended by that in the slightest. So if you feel that you’ve had some investigations, you’ve had some simple treatment, you are not getting better; it’s okay to actually ask the GP, “Can I see a specialist about this?” And I think most GPs would welcome that opportunity and hopefully your GP will have a good communication strategy with their local rheumatologist. They should be able to pick up the phone or send a fax and say, “I’ve got someone who I think has got rheumatoid arthritis or ankylosing spondylitis,” and that is an urgent case for the rheumatologist to see.
GPs are very reliant upon you, the patient, telling them how you feel and what you think is wrong with you. And I said, “Pretty sure I got gout, Doc” and consequently was diagnosed with gout; obviously the symptoms were similar and on and on and on that went until I got to the point where I thought I needed to seek advice and that’s your responsibility to do that.