Why Do I Need So Many Doctors?

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By ACCORDANT HEALTH SERVICES

If you have CF (cystic fibrosis) you may see three or four doctors—or maybe even more. You probably also see other types of health care providers. Have you wondered, "Are all of these really necessary? Seeing so many different health care providers can take a lot of time and be tiring. Sometimes you might wonder what all the different people do and if it is even worth it.

Today, there are more than 145 medical specialties. There are so many specialties because no one doctor can know everything about every illness. This is especially true when it comes to a complex long-term illness like CF. This is why many doctors choose to become specialists. Specialists are experts in just one area of care. They work with other doctors to care for people with chronic conditions like CF.

The team approach is the best way to make sure that you get the very best CF care. Your CF team watches your growth, provides advice, and plans your care to help you stay as healthy as possible.

A CF health care team often includes these members:

• CF Doctor. This doctor leads the CF care team. Often this doctor has internal medicine training, as well as training and experience with CF. He or she teaches other doctors and health care providers about CF. He or she may also do CF research. The CF doctor works with your pediatrician or family doctor to ensure the best care.
• Nurses. Nurses can have different roles on the CF team. Nurse practitioners or nurse specialists have more training than other nurses. They work closely with the CF doctor and help the other nurses coordinate patient care and education. A CF nurse has extra training in CF care. He or she helps organize the team and teaches you and your family about CF.
• Dietitian. A registered dietitian gives advice about nutrition. A dietitian advises those who are underweight or malnourished, or at risk for these problems. He or she advises children and parents about enzymes, vitamins, and high-calorie diets. A dietitian can also help with eating behavior problems.
• Social Worker. The social worker's role is to help ensure a good exchange of ideas and concerns between the family and the care team. He or she also teaches the family how to deal with the stress of an ongoing illness. The social worker helps get teens ready to be on their own. The social worker also helps answer questions about the cost of CF care.
• Psychologist or Counselor. Psychologists and counselors are mental health workers. They can help children, teens, parents, and families cope with the stress of CF. They can support those who feel grief or fear. They can also teach ways to manage or change children's behaviors. Some counselors can help with spiritual issues too.
• Your AccordantCare Nurse is another source of information and support for you. Your nurse is always happy to answer your questions and talk about any concerns you have.
  Pulmonologist. This doctor is an expert in diseases of the lungs and airways. He or she tests lung function and orders medicines or devices that help patients breathe better.
• Gastroenterologist. This doctor is an expert in problems of the digestive tract. He or she is an expert on the esophagus, stomach, small and large intestines, pancreas, and liver. Gastroenterologists do tests when there are symptoms like stomach pain.
• Endocrinologist. This doctor works with those who have illnesses that involve hormones. Endocrinologists treat conditions like diabetes, thyroid problems, osteoporosis, or not having enough growth hormone.
• Worship Leader. This person can offer spiritual support and a listening ear. He or she can help children and parents adjust to life with a chronic illness. A chaplain can provide emotional support and a pastoral point of view when decisions must be made.
• Respiratory and Physical Therapists. A respiratory therapist gives breathing tests, and is responsible for the care and use of equipment such as nebulizers. A physical therapist teaches people with CF about the benefits of exercise. He or she designs exercise programs based on a person's disease severity, fitness level, and preferences. When someone with CF is in the hospital, either type of therapist can provide airway clearance and other treatments. They also teach people how to do their own care at home.
• Child Life Specialist. The child life specialist teaches skills for dealing with the stress of CF. The child life specialist also designs activities for visits to the clinic or the hospital. This includes play therapy that helps children of different ages understand their treatments.

Your AccordantCare Nurse is another source of information and support for you. Your nurse is always happy to answer your questions and talk about any concerns you have. He or she will work with you one-on-one to help you follow your CF care plan.

References

American Board of Medical Specialties Web site. Accessed April 24, 2008.

Cunningham JC, Taussig LM, An Introduction to Cystic Fibrosis for Patients and Families. Fifth edition. Cystic Fibrosis Foundation; 2003.

Yankaskas JR, Marshall BC, Sufian B, Simon RH, Rodman D. Cystic fibrosis adult care: consensus conference report. Chest. 2004;125(1)(suppl 1):1S-39S.

Borowitz D, Baker RD, Stallings V. Consensus report on nutrition for pediatric patient with cystic fibrosis [medical position papers]. J Pediatr Gastroenterol Nutr. 2002;35(3):246-59.

Counselors. Occupational Outlook Handbook, 2008-09 Edition. Washington. D.C.: Bureau of Labor Statistics, U.S. Department of Labor. Updated December 18, 2007. http://www.bls.gov/oco/ocos067.htm . Accessed April 24, 2008.

American Association of Christian Counselors Website. Accessed April 24, 2008.

American College of Physicians Web site. Accessed July 23, 2008.

American College of Physicians Web site. Accessed July 23, 2008.

American College of Physicians Web site. Accessed July 23, 2008.

Children's Hospitals and Clinics of Minnesota Web site.  Accessed July 23, 2008.

Gumery L, Dodd M, Parker A, Prasad A, Pryor J, Kennedy N, eds. Clinical Guidelines for the Physiotherapy Management of Cystic Fibrosis. Bromley, United Kingdom: Cystic Fibrosis Trust; 2002.

Last Modified Date: March 19, 2009 © Accordant Health Services, a CVS/Caremark company.  All rights reserved.
This article has been reviewed for accuracy by a member of the Accordant Health Services Medical Advisory Team.
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