In a region where the typical waiting time to see an adult rheumatologist can be at least 4-5 months, Aryeh Abeles, MD, can see patients within a week in his Meriden, Connecticut, private practice — even within a day if the need is urgent.

Aryeh Abeles, MD

But many patients, he said, don’t reach his practice. Their primary care physicians (PCPs) practice within the large healthcare systems that dominate the region and are discouraged from making out-of-house referrals to independent rheumatologists, even when in-house waiting times are lengthy.

Abeles recently saw one patient — an older man presenting with severe and disabling symmetric hand and wrist pain — who was referred to a rheumatologist at Hartford HealthCare but faced a 3-month wait time and eventually demanded another option.

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