Would My Care Benefit From A Pulmonologist?

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A pulmonologist is one of the specialists you can see for your asthma. Considered a respiratory specialist, you will most likely be referred to a pulmonologist, but you may request an appointment just like you would a primary care physician.

What Is A Pulmonologist?

Many people refer to pulmonologist as lung doctors. These doctors primarily focus their medical practice on diseases of the lungs and respiratory system.

After medical school, pulmonologist must first complete a general internal medicine residency and then complete an additional training program that focuses on the respiratory system. Many physicians also include training in critical care medicine to complement their pulmonary training. The training is generally 2 or 3 years.

Pediatric pulmonology is completed after a pediatric residency and the training covers respiratory diseases in children. Pediatric pulmonary doctors do not usually include critical care training as part of a pulmonary fellowship and the training is 3 years in length.

What Does A Pulmonologist Treat

In addition to asthma, a pulmonologist treats many different respiratory conditions. Examples include:

  • Chronic cough
  • COPD
  • Cystic fibrosis
  • Interstitial lung disease
  • Lung cancer
  • Pneumonia
  • Pulmonary hypertension
  • Sleep disorders
  • Tuberculosis

Many pulmonologist also practice critical care medicine and manage patients that require intensive or ICU care in hospitals.

They also manage patients who require chronic ventilators to assist with breathing.

What Are The Advantages Of Being Treated By Pulmonologist

If your primary care doctor is unable to help you achieve good asthma control, a respiratory specialist will hopefully help you decrease asthma symptoms such as:

When Do I Need A Specialist?

A pulmonologist will most likely get involved with your asthma if your regular doctor is not able to get adequate control or has questions they do not think are within their scope of practice.

I also refer to pulmonologists when patients or parents are concerned or if there is a question about an asthma diagnosis. You may want to consider seeing a pulmonologist in any of the following scenarios:

  • You experienced a life threatening asthma attack or were admitted to an intensive care unit.
  • You experienced a hospitalization where the trigger was not able to be identified.
  • Your asthma remains poorly controlled after 3–6 months of treatment and you were following recommendations of your doctor.
  • You want an evaluation treatments like bronchial thermoplasty.
  • You needed oral steroids more than once per year.
  • You have moderate persistent or severe persistent asthma despite appropriate treatment and following instructions.
  • You need more education than your primary care physician can provide.

    I am also commonly asked if subspecialty care is better than receiving care in only your primary care doctor’s office.

    My answer is usually “it depends.” Patients cared for by subspecialists more likely are sicker and have more complicated asthma. So it is not really comparing apples to apples. However, there have been some studies that demonstrate some improvement in outcomes such as a higher percentage of patients being on inhaled steroids and other measures.

    Do I Need A Primary Care Doctor

    In full disclosure I am a primary care physician, so it will not likely surprise you when I say yes. Many of my new patients are referred to me from subspecialists like pulmonologists. I often find parents and patients that want to only go to one doctor. If asthma is your only significant health issue than I understand.

    However, many subspecialists do not want to take responsibility for or feel comfortable for the other aspects of your routine wellness care like screenings, immunizations, and other routine non-asthma related medical illness like diarrhea, constipation, anxiety or arthritis. Just as your pulmonologist is an expert in asthma, your primary care physician would be most up to date in these other areas.

    What Is Your Biggest Asthma Problem?

    We want to help you get control of your asthma. I want to hear about your biggest asthma problem so that we can try to help you develop a solution or better understand how to help.
 You are probably not the only one with the problem. Take a few minutes describing your problem so we can develop a solution together.

    Sources

    1. Alford G. When Do You Need an Asthma Specialist? Asthma Magazine. Volume 8. July-August 2003.
    2. National Heart, Lung, and Blood Institute. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma. Accessed on April 24, 2015.

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