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CLINICAL REVIEW: Carol Simpson, Chloe Franks, Catherine Morrison, and Heidi Lempp The patient's journey: rheumatoid arthritis BMJ 2005; 331: 887-889 [Full text]

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The patient's journey: rheumatoid arthritis

Louis I Jones   (12 November 2005)

The patient's journey: rheumatoid arthritis 12 November 2005
Louis I Jones, Retired GP Bristol BS41 9JD Send response to journal: Re: The patient's journey: rheumatoid arthritis	Editor;In Carol Simpson et al's article it states "optimal treatment is now seen to be care provided by a multidisciplinary team etc" This is not necessarily the case. In many hospitals after the initial diagnosis by a consultant, future follow up visits are often by a succession of SHO, who are unable to provide either the expertise or the continuity of care that the the patient needs. In my 30 years as a GP in a 4 doctor practice (1968-1998) I treated the majotity of patients with RA myself.I soon became expert in when to change drugs (increase in symptoms,increase in ESR, abnormal blood tests,other side effects) including methotrexate and corticosteroids. One patient was able to keep working for 15 years after diagnosis. The key was frequent follow-ups by the same doctor (at least every 4 weeks), without hospital attendance. Chloe is also wrong to state that RA is generally associated with old age. Louis Jones Retired GP, Bristol BS41 9JD Competing interests : none 1Carol Simpson,Chloe Franks,Catherine Morrisonn,Heidi Lempp.The patients Journey:rheumatoid arthritis.BMJ 2005;331:887(15th October) Competing interests: None declared