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I'm trying to locate online the "standard of care" for

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rheumatologists. Is this information assessable...
I'm trying to locate online the "standard of care" for rheumatologists. Is this information assessable online? I saw a rheumatologist for 1 year and he prescribed 12 different medications including Lyrica, Tramadol, Hydrocodone, etc which I believe caused serious side effects. He never recommended any other therapies or alternatives besides the dozen medications and after 1 year then he "dismissed" me from his practice saying he doesn't know whats wrong with me.
Submitted: 8 years ago.Category: Medical
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Answered in 19 minutes by:
6/22/2010
Doctor: Dr Chip (M.D.), Doctor replied 8 years ago
Dr Chip (M.D.)
Category: Medical
Satisfied Customers: 38,463
Experience: 20 yrs. in practice, including surgery, general medicine, addiction medicine and pain.
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What's the condition for which he prescribed all those medications?
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Customer reply replied 8 years ago
The "condition" kept changing at every appointment for what he was treating me. Diagnosis he made at office visits within my medical records progressed as follows:

Myalgia and Myositis Nos (3 visits)
to ***** Pain-I/leg (1 visit)
to ***** (1 visit)
to ***** (1 visit)
to
Myalgia and Myositis (1 visit)
to ***** Nec (1 visit)
to ***** (1 visit)

The only diagnostic tests he ran were the same blood work over and over again and 1 MRI (of my knee after I had slipped on a wet floor). He also had 1 ultra sound of my lymph nodes in my neck done which showed enlarged lymph nodes (only reason why he had the ultra sound done is because I complained the endocrinologist he personally recommended me to did not take a thorough health history, and without any additional testing, started me on thryoid treatment to which I had a bad reaction). When the rheumatologist "dismissed" me from his practice saying I don't have any rheumatologic disease, it was after my last 2 appointments when I mentioned I researched lyrica and tramodol on the FDA website about and many of the side effects I was experiencing seemed to be from the combination of prescribed medications. Since stepping foot into this doctor's office in 2009, my health has been the WORST over the past year since 2004...and since stopping all the medications and not seeing this doctor the past 1.5 months a large multitude of these "new" symptoms are finally gradually subsiding. Over this past year at each appointment, I questioned if the medications were the source of my "new symptoms and problems" and his "course of treatment" was to prescribe 1-2 more medications on addition to the medication I questioned. Reviewing my medical records from his office they do not reflect all the side effects I reported and questioned during my doctor's visits over this past year. Half way through this year, I also insisted he review my extensive previous medical records of testing previously done by other specialists (including another rheumatologist) which contains many abnormal test results (and doctors notes suggesting a type of connective tissue disease or autoimmune disorder) to which he replied he does not NEED to review or see anything else. So he did not review any information than the small amount of the same tests he kept running. Is this the standard of care?
Doctor: Dr Chip (M.D.), Doctor replied 8 years ago
Yours is an interesting question, and, I do have a response, but, first, I'd like to ask if you are looking for me to agree with you about his not being thorough, or were you considering filing a formal complaint about him? Also--what happened with the previous rheumatologist?
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Customer reply replied 8 years ago
Well as I stated, initally I tried doing an internet search to find "Standard of Care" practices for Rheumatologists and couldn't find any specific information which brought me to this website. I am considering filing a compliant or seeking legal advice if it is warented (guess that's what I'm trying to determine...was the "standard of care" not followed?) It should also be noted, I went to my primary MD in Feb. 2009 asking for a referral to pain management bc I was still having extreme pain and discomfort from my ACL reconstruction from Oct. 2007, and my primary said I don't need pain management I need a rheumatologist and he referred me to this rheumatologist office which I started seeing in March 2009. (Side note, my knee still has almost the same amount of pain, swelling, numbness in the incision site and surrounding areas as it did after the operation in 2007 and no further assessment of this knee has been done via diagnostic imaging by my orthopedic or primary MD).
In answer to the other rheumatologist, she treated me for aprox. 2 years and was questioning the CREST version of Scleroderma.
Doctor: Dr Chip (M.D.), Doctor replied 8 years ago
OK. Standard of care refers to what other specialists in the same field would do or not do in a given patient scenario. Except for looking up diagnostic work up and treatment for certain symptoms or diseases, you won't find a site that specifically addresses "standard of care" for a rheumatologist. It doesn't look like there was a lack of diagnostic testing, and, I agree, you were given a multitude of medications, all with possible side effects and disagreeable interactions. For a malpractice suit to be valid, it must be shown that a given doctors actions or inactions either caused permanent damage to the patient's health that could have been avoided or lessened by appropriate diagnosis and/or treatment. Only an experienced malpractice attorney could tell you whether you have a case here.
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