Building a positive rapport with a NEW doctor

Well folks, my dream of finding a new rheumatologist may come true. I was at the hospital today getting my heart checked out and my cardiologist (who is Top Notch!) recommended a rheumatologist who works down the hall from her office.

Strangely enough, a good friend recommended that I see this rheumatologist. I had an appointment scheduled for end of August with the new rheumie but thought I would stop by and see if they could give me an appointment sooner rather than later.

Well, as I was talking to the receptionist the doctor popped around the corner and Shazam! I have an appointment with the new rheumie tomorrow!!! YAY!!! There is light at the end of the tunnel!!

So that I start things off on a good note, what are some suggestions for how to build a positive relationship with the new doctor tomorrow? How to structure the “agenda” so that I don’t overwhelm her immediately with symptoms and complaints?

I will do paperwork in advance but since my track record is so poor, I’m looking for any recommendations you can think of to get started in a positive manner.

Thanks in advance for your help!!!



New doctor? Some like to set the "agenda" themselves. I mean they pick the order in which they collect information and then the physical exam too. I always jot down a note of main symptoms/issues that I would like addressed, just a few, prioritize them and the others can always wait for the next visit. I also write the questions down that I would like answred too, just a few really important ones. I try to stick with what needs immediate attention. That usualy works out well for the doctor and for the patient because you don't waste time. You dont' want to run out of time and not have the important issues addressed.

My one doctor asks me "ok, do you want to go first, or do you want me to go first?" that works good too. I like that. I update him first and then I shut up and let him do the talking.

Hope that helps.


Hi Sunny,

That was good advice from allergic, who is a nurse. I do the same, though in your case, you may want to give them a list of symptoms family history, to keep for their records, but have a few questions.

My Doc examines me, asked his questions, if what I want to know is not covered, then I ask mine.

Take a list of current meds, the regular mix and the as needed, and know some of your history as they will ask for it, easier to have it written down than to rack your brain especially for dates.

The biggest thing I have had to learn is to allow them to lead, and allow them to diagnose. They like informed patients, but not self diagnosing ones, and realize it may take some blood work and tests before you get a diagnosis.

I hope this one is 'the charm' for you Sunny! I hope you get the care that you deserve!



Allergic and SK,

I met the new rheumatologist and am still deciding whether or not the visit went well. The doctor was very quiet and I am not sure how to read her body language. I developed a short script but the conversation was a bit awkward at times so I didn’t get through my symptoms. (I brought my list)

She referred me out to get several tests plus I have the tests which the cardiologist ordered yesterday. One thing which surprised me is that she does not prescribe pain medication, I would have to see a pain management doctor. She also doesn’t believe in prescribing it for fibro which makes me think she is not too experienced with it. What are your thoughts?

I feel like it would be a real PIA to describe symptoms to both a pain mgt person plus her to get my fibro under control. I think she sensed I was a bit surprised and hopefully didn’t think I am a junkie. So the appointment seemed short as I got a bunch of referrals, a quick recommendation to come off the Savella (I can’t urinate normally) and she asked me to return in six weeks. (even after I told her about my strange symptoms lately)

I will keep looking, and make an effort to schedule something with SK’s doctors. Appreciate any and all feedback


I haven't come across that type of protocol myself with any of the rheumatologists that I've gone to. So she just orders tests and sends you to the pain management doctor? Usually, the rheumy's prescribe pain meds then if you fail their treatment really bad, THEN they send you to a pain clinic. Is the pain management doctor in the same office at least?

If she doesn't believe in prescribing pain meds for fibro, then what DOES she believe in doing for her fibro patients? Wonder if she even believes that fibro is real? Did you ask her? Sounds wierd unless she just limits her practice to other conditions and just is some kind of "gatekeeper" for fibro patients.

You said your friend referred you to her, so does your friend have fibro ?


My friend has RA and is on Remicade. The pain mgt doctor is not in her office. And they had signs posted about how you must pick up prescriptions for narcotics and show an ID. So that twirked me off because obviously the other doctors in the practice DO prescribe them.

I wonder if she thinks it is a real problem to have fibro?? I can only find good feedback about her on the web so this is confusing me.

Yeah, but is the good feedback from fibromyalgia patients? Or from patients with other conditions?

Maybe the office has a policy on prescribing narcotics, only for certain conditions, excluding fibromyagia? I wonder if the other doctors in the group prescribe narcs for fibro?

So much for a good rapport. That would tick me off.

i was so hoping to hear u had a good visit. i am so sorry i didnt go well. i would look into the dr too see if she treats fibro patients cause maybe she doesnt treat thst many and that is why she did what she did. i have heard pain clinics can b really helpful but it is another dr to have to go and more money spent on copays. but then maybe that might b the answer for u. i know u r suffering and need help. i really hope u can find it soon. if i were u i would give the pain clinic a try maybe they might b the answer u need. but i would also maybe consider another rhumy dr in that office.

good luck lots of hugs

Well, my rheumy didn't give me any pain meds, plus said he doesn't treat with Lyrica as he doesn't think it helps much and gives lots of side effects. He did recommend me to a pain center if the one I'm going to doesn't help. He did recommend me to a neurologist for the dizziness. He recommended tai chi and a few other things.

So it sounds like we had similar visits.

Maybe she feels that the pain mgmt center can do more than just prescribe pain killers in helping you with the fibro? That's what my rheumy said. I haven't gone to them yet as I'm still with the initial pain mgmt place. You might want to give it a try, Sunny. Also, you could ask the doctor why you need to go if her office prescribes narcotics (maybe for different issues?)

Do you guys really get relief from narcotics? I've never found them useful at all in getting rid of much - or any - pain, plus I just get horribly sleepy.

Petunia...I avoid all rx drugs. I only use my thyroid medicine and keep Tramadol on hand just for emergency fibro flares, only if all else fails just to break the pain cycle and keep it from escalating. Couple days and I stop. I use it so infrequently that my prescriptions expire. My diet and eliminating foods that I am sensitive or allergic to, and reducing stress levels made that possible. Before I did that, I was a total mess. That's why I'm such an advocate for holistic medicine and doctors who try to find other alternatives besides just rx drugs and narcotics.

Dear Sunny,

My Rheumatologist does not prescribe pain meds either, they want to treat the disease, not the pain, but ideally in treating the disease, they do indeed treat the pain, to some degree. With many patients and limited time, they focus on diagnosis, treatment, slowing progression...

If she is on the school of thought of my Rheumatologist, and consider FMS a condition, caused by a disease, they may not prescribe pain pills for a condition, as it may not considered a full diagnosis. Many of the newer Doctors will not prescribe pain meds regardless, they feel it only compounds problems, makes pain worse.

These are just things I have learned along the way.

Hope that helps you figure this out, OBTW, only hand them ONE of the orders if the tests are identical, otherwise you will end up paying out of pocket for one of them.

Hope you feel better soon,


Narcotics help with the killer hip and back pain. I have spinal stenosis and other fun things… I don’t see that I can do without a strong med for these issues unless I have surgery.

I’ve tried PT, chiro, acupuncture, yoga, meditation

Meloxicam helps osteoarthritis and Lyrica helps with the flu like pain all over my body.

I would rather take NO medication but I am not seeing how that is possible. I learned that I cannot take aleve, Motrin etc due to something called gastroperisis. However, I can take Tylenol based products.

Thanks for all of the support.

To clarify, I go to a pain clinic now. That is where I get the SI joint, L4/5 injections, trigger point injections

The current rheumie that I have been seeing is the only one who can prescribe pain medication (per the rules, unless I leave his practice). I don’t take much pain medication now - I was just annoyed that I would have to pay 2 co pays to get fibro meds and then a pain medicine. Seemed like the same person should do both

I know the frustration of all the Doctor appointments, all the specialists, having to go here for this, there for that is maddening!

Perhaps one day they will treat us as 'one unit' under one roof!

Wishing you a good night, Sunny!


I’m sorry for asking again, but could you please email me those numbers again ? My brain is so foggy. I left a message for a doctor and am hoping it is the right person! Argh

i agree with u that u shouldnt have to go to two different for meds for fibro. maybe if u can get in with anther dr u will be able to get both from one dr. i am unable to see a rheumie dr due to no insurance the same goes for a pain clinic. the only time i get strong scripts for pain meds is from the ers at times and they usually give less than 15 at a time with no refills. while i dont need them to get through each day it would b nice to have on hand for nights and days when the pain brings tears to my eyes.

i feeel bad for u cause i know u have several painful conditions and i cant imangine being in your shoes. i do hope u can find the right dr who will treat u good and give u what u need. its crazy all that u have been through with drs. i pray u can find the right one soon.

Hi Sunny,

I think the problem is that the government is really cracking down on narcotic prescriptions being written. All doctors are afraid to write them now, especially when they see other doctors being arrested in the paper for over-prescribing. All of my doctors have started posting those notes that "no pain meds given. You must go to Pain Management". You would think that a Rheumatologist, of all doctors, would be able and willing to write them, due to the fact that every disease he treats is chronic pain related.

Now, I heard from my surgeon that there is going to be some new laws put into effect regarding the pain prescriptions that are really going to put doctors in a tough position. What the law actually is, or when it's going into effect, I don't know. But from what I've seen and heard, it all comes down to fear of losing their medical licenses for what the government decides over-prescribing. If that's the case, pain medicine is going to be one hell of a money maker !

I'll try and do some research to find out more and let you know. I just heard about these new laws the other day, and wanted to stick my 2 cents in!


You're right, Renie. I think we're in for a rude awakening when it comes to healthcare and government control. Prepare for the worst, but hope for the best. That's all you can do. Alot of doctors may just pack it in or really have to change their practices drastically to survive. Some may leave altogether and go into other fields where they don't see patients. Just my observation.


Thanks! I think that things are getting out of control. It’s so frustrating

Several of my doctors have already left their own private practices and moved into the big conglomerates -- you know, the ones that have 200 doctors on staff, and they turn them over so fast you never know if you'll ever see the same doctor twice?
The doctors get partially covered by the groups malpractice insurance, so I'm sure that's why they are all moving to bigger will that mean no more private, single doctor practices, because of the liability?
Healthcare in this country is a mess. Like Sunny said below, everything is out of control. If they take away easy access to pain meds, does that mean people are going to be desperate enough to start buying drugs on the street? Scary thoughts.