Rheumatology (IM)

What is a rheumatologist?

A rheumatologist is an internist who treats diseases of joints, muscle, bones and tendons. This specialist diagnoses and treats arthritis, back pain, muscle strains, common athletic injuries and “collagen” diseases.

A subspecialty in internal medicine and pediatrics, rheumatology is devoted to the diagnosis and therapy of conditions and diseases affecting the joints, muscles and bones. While orthopaedics involves surgical treatment for fractures, injuries, and diseases, rheumatologists deal mainly with clinical problems involving joints, soft tissues, certain autoimmune diseases and the allied conditions of connective tissue.

What does a rheumatologist do?

The practice of rheumatology is a blend of the basic clinical skill of physical examination and the rapidly expanding science of immunology. Clinically, the diverse nature of rheumatic diseases keeps a rheumatologist as sharp as an internist and facilitates positive interactions with most internal medicine specialties. The number of people with arthritis is mushrooming due to population increases and longevity. By 2030, it is expected that 67 million Americans will have been diagnosed with arthritis, up from about 50 million in 2011.6

Besides interactions, medical students considering a career in rheumatology should enjoy, namely, the exchange between a patient and physician during the diagnostic performance of history and physical examination. The rheumatologist’s approach is a comprehensive one, involving close attention to details of the history and examination in order to detect clues that unravel the cause of the symptoms that prompted the clinical encounter.

Rheumatology patient care exists in both ambulatory (outpatient) and inpatient settings. As such, the outpatient setting provides optimal flexibility to schedule patient hours in a personal/family-friendly way. At the same time, it is important to note that a subset of patients with inflammatory rheumatic disorders may be admitted to the hospital with acute, and at times, life-threatening illnesses that warrant meaningful daily care in the inpatient setting. Sharing such inpatient responsibilities with colleagues creates a desired work-life balance.

There are extensive opportunities for direct patient contact in rheumatology; patients who present to a rheumatologist span the entire life span, from the neonate to the centenarian. Rheumatic disorders affect both genders and all racial and ethnic groups. The duration of the physician-patient relationship varies. It’s common for rheumatologists to have long-term follow-up care with their patients, often for greater than a decade. Yet time-limited consultative interactions exist as well.