By Alicia Cowley, MD, MBA, Internist & Medical Director of Network Solutions, Phreesia
As a primary care physician-turned-hospitalist-turned-medical director at a healthtech company, I’ve seen firsthand how healthcare evolves across settings and specialties. Internal medicine physicians like myself are uniquely trained to manage a wide array of chronic health conditions, from diabetes to heart disease to autoimmune disorders. But there are pivotal moments in a patient’s journey when deeper, more specialized care becomes necessary. In those moments, the right specialist can make all the difference.
The value of specialized expertise
Primary care physicians (PCPs) and internists are the backbone of chronic condition management. They know your history, understand your lifestyle and often serve as the first to detect when something isn’t quite right. But chronic conditions can be complex and unpredictable. At times, they progress in ways that demand a more nuanced understanding, specialized tools or cutting-edge treatments that fall outside the scope of general practice.
That’s where specialists come in.
A cardiologist, endocrinologist, rheumatologist or another subspecialist brings years of focused training to a specific area of medicine. Their involvement doesn’t mean your PCP has failed—far from it. It’s a sign that your care is evolving, becoming more tailored and precise. Think of your specialist as an added layer of support, not a replacement for your trusted PCP.
Patients often fear that seeing a specialist might lead to fragmented care, but you can play a powerful role in keeping everyone aligned. Share your specialist’s recommendations with your PCP, bring copies of test results and imaging reports to appointments, and ask both doctors to coordinate directly when possible. You also have the right to request a copy of your medical records, lab results and imaging from any provider or facility. This can usually be done through your patient portal, a written request or by contacting your provider’s medical records department. The specialist may take the lead for a time or provide recommendations your PCP can follow long term. Either way, you benefit from their collective expertise.
When it’s time to see a specialist
So how do you know when to seek out a specialist or subspecialist? Sometimes your PCP will refer you. Other times, you might notice changes in your health that signal a need for more focused care.
Here are common reasons someone with a chronic condition may need to “level up” their care:
- Worsening or persistent symptoms: Your usual treatment isn’t working, or your symptoms are becoming more severe.
- Need for specialized testing or procedures: You require diagnostic tools or treatments that are only available through specialty care.
- Desire for advanced treatment options: You want to explore therapies, clinical trials or interventions not widely available.
- Multiple comorbidities or complex cases: When several conditions interact in complicated ways, a specialist can help untangle the web.
- Rare or poorly understood conditions: If you’ve been diagnosed with a rare disease or are experiencing unexplained symptoms, a rare disease specialist may be your best guide.
It’s important to listen to your body and advocate for the care you need. If something doesn’t feel right—even if your labs are “normal”—it’s worth asking whether specialty care could help.
Chronic conditions that benefit from specialist involvement
While PCPs are well equipped to manage many chronic conditions, there are times when specialist care can dramatically improve outcomes. Whether it’s due to disease complexity, treatment resistance or the need for advanced diagnostics, involving a specialist can bring clarity, precision and new options to your care. Let’s explore a few common chronic conditions where specialist involvement can make a meaningful difference:
Diabetes: For many people, diabetes can be managed well by a PCP. But when blood sugar remains poorly controlled, complications arise or multiple medications are needed, it’s time to bring in an endocrinologist. These hormone-focused specialists have deep expertise in insulin regimens, continuous glucose monitoring and newer therapies that can prevent long-term damage. Their expertise can fine tune your treatment and help prevent long-term complications, especially in complex or brittle cases.
Heart disease: Cardiovascular conditions remain a leading cause of death, and managing them often requires specialized care. A cardiologist can assess issues like resistant hypertension, arrhythmias and heart failure with diagnostic tools that go beyond a basic office visit, such as stress tests, echocardiograms and cardiac catheterizations. If you’re experiencing chest pain, shortness of breath or have a family history of heart disease, a cardiologist can help clarify your risk and recommend interventions that may prevent serious events down the line.
Neurological disorders: Conditions like epilepsy, Parkinson’s disease, multiple sclerosis and chronic migraines can benefit from the expertise of a neurologist. These specialists use imaging, electrophysiology and targeted therapies to manage symptoms and slow disease progression. If you’re experiencing neurological symptoms, such as numbness, tremors or memory changes, a neurologist can help identify the cause and tailor your treatment.
Autoimmune and rheumatic conditions: Rheumatologists specialize in conditions like rheumatoid arthritis, lupus and psoriatic arthritis, where the immune system mistakenly attacks the body. These conditions can be difficult to diagnose and manage, and they often require immunosuppressive medications or biologic therapies. If you have joint pain, fatigue or unexplained inflammation, a rheumatologist can help guide your treatment.
Cancer: Facing a cancer diagnosis is overwhelming, but it doesn’t mean your only focus has to be on survival. Palliative care specialists work alongside your oncology team to improve quality of life during treatment. This can include managing nausea, fatigue, pain, emotional distress and side effects from chemotherapy or radiation. Importantly, palliative care is not limited to end-of-life care, it’s about helping patients feel better while actively pursuing treatment. It’s a layer of support that honors both medical goals and personal wellbeing.
Find the right specialist for your needs
Once you’ve decided to seek specialty care, the next challenge is finding the right doctor, someone who understands your condition, aligns with your preferences and practices in a location that works for you. With thousands of specialists across subspecialties, the search can feel overwhelming.
That’s where MediFind’s Doctor Finder tool comes in. Whether you’re managing diabetes, heart disease, rheumatoid arthritis or another chronic condition, MediFind helps you search by condition, specialty, insurance and geography. But it goes beyond basic filters. MediFind uses data-driven insights to identify top-performing physicians who have experience with your specific diagnosis. You’ll see doctors who publish research, participate in clinical trials and receive high ratings from their peers. Whether you’re looking for a diabetes specialist, heart doctor or rare disease expert, MediFind’s Doctor Finder tool can streamline your search and increase your confidence.
When possible, involve your PCP in the selection process. They may have trusted recommendations or insights into which specialists work well with your overall care team.
The bottom line
PCPs are essential in guiding your chronic care, but specialists add precision, depth and options that general practice can’t always offer. If you’re struggling with symptoms, facing a complex diagnosis or simply want to optimize your care, don’t hesitate to find a specialist.
Ready to take the next step? Try our Doctor Finder tool to explore your care options and connect with the expertise your health deserves.
