[jyl]

I also feel that gout is poorly treated. It takes a long time to get into to see a rhuematologist. They then treat gout very conservatively, starting drugs at very low doses and taking many months to consider raising those doses. They fail to warn patients that starting allopurinol often triggers flares, and often fail to prescribe prophylactic colchicine, with the result that many patients don't stay on the drug that will help them. They are also very slow to try new gout drugs, Uloric was on the market for a year and my rheum said she would wait a couple more years before trying out on a patient or two. They don't push dosages high enough. My feeling is that for a rheumatologist, gout is one of the less serious diseases they treat, the patient is often asymptomatic when they are seen, since the flare ended before an appointment was available, so the rheumatologists I've seen don't seem to take the condition all that seriously. Last complaint, they seem to do so much testing to confirm gout, before starting to treat it. It is possible to have gout and flares without uric acid crystals in the joint fluid and even without high serum uric acid (sUA) levels. I told my GP doc friend about the 8 months of testing (and pain, and walking with a cane or crutch) I went through before anyone decided to treat me with gout drugs, and he laughed out loud. "I'd have given you colchicine, if it helped, start treating you for gout".