I addition to the systemic shortcoming mentioned above, I see that fragmentation of medical care by specialists makes the patients feel confused as to the overall direction of the healthcare. I find myself in the situation having to explain clinical insights to the patients on issues that should have been communicated by the other physicians they see. Rather than focussing on specific inflammatory diseases we are competent to manage, patient are often sent to us with the vague idea that "something autoimmune" is the underlying cause of their multiple clinical symptoms. Rheumatology does at time lack the precision other internal medicine subspecialties such as Cardiology and Hematology have which creates additional impression of vagueness in clinical practice.
I addition to the systemic shortcoming mentioned above, I see that fragmentation of medical care by specialists makes the patients feel confused as to the overall direction of the healthcare. I find myself in the situation having to explain clinical insights to the patients on issues that should have been communicated by the other physicians they see. Rather than focussing on specific inflammatory diseases we are competent to manage, patient are often sent to us with the vague idea that "something autoimmune" is the underlying cause of their multiple clinical symptoms. Rheumatology does at time lack the precision other internal medicine subspecialties such as Cardiology and Hematology have which creates additional impression of vagueness in clinical practice.