Coordination of Care

My readers with multiple health issues will probably understand this. Those without multiple health issues or complex conditions may not have experienced this personally.

People with multiple health issues or complex conditions typically have multiple physicians.  Health care is so specialized these days.

I personally have a primary care physician, a rheumatologist, a psychiatrist and an acupuncturist (yes, she is a physician) that I see regularly.  Each treat different things.  None communicate much, if at all (my PCP referred me to the rheumatologist, so I think there was a little communication there in the beginning, at least a few records faxed back and forth).  Three of them prescribe medications and they are only aware of what the other prescribes because I tell them.  My pharmacist and I look out for possible medication interactions. I also take lab reports about blood work or other labs ordered by one physician to the others so they all have copies.

So I've been feeling lousy lately, feeling like something is off and maybe I need some meds changed for something. But here is when having multiple doctors is a problem.

If I'm feeling more anxious and depressed, I should probably see my psychiatrist, right? But depression can sometimes, though apparently not often, be a side effect of the medication I take for fibromyalgia. Which was just increased recently. So should I see my rheumatologist instead? And if my psychiatrist wants to try a different antidepressant, that will probably mean stopping the one I'm on first, but in addition to being an antidepressant it is used to treat pain, so if I stop taking it my fibro pain may get worse, so should I discuss that with my rheumatologist first? 

Ideally my psychiatrist and rheumatologist would have a discussion about these things, but do you know how hard it is to get two doctors that do not work for the same practice to have a conversation? Sigh.