Find the Best COPD Care Team for You
Whether your symptoms of chronic obstructive pulmonary disease (COPD) came on gradually or suddenly, one thing remains the same: You’ll need to seek treatment for the condition right away. “There are some people who are quite stable for many years, and some people have a more rapid progression,” says Craig Hersh, M.D., a pulmonary-medicine specialist at Brigham and Women’s Hospital, in Boston. “You can’t look at someone and predict in five years what it’s going to be like.”
While many cases of COPD can be managed with only the help of a primary care doctor, other people—such as those with more advanced conditions, or people who have related complications—may need to recruit a network of specialists to their roster.
How to Find the Right Doctors for You
If you have a primary care doctor, you may not need to seek out another addition to your healthcare team. But if your condition worsens, or you want to seek a second opinion, here are a few ways to find the specialists you need:
Ask for a referral. If your primary care doctor isn’t able to manage your COPD, ask them to refer you to a local pulmonary specialist whose practice they have experience working with. “It’s those patients who have complex or advanced disease who may need assistance from a pulmonary physician to help manage their symptoms,” says Pushan Jani, M.D., a pulmonologist at UTHealth Houston. Your health-insurance company may also require you to seek out a referral before it will cover the costs, according to the American Lung Association (ALA).
Make sure they’re available. If you’re experiencing frequent exacerbations (flare-ups of the disease) or are having difficulty breathing, you’ll need to see a doctor right away—so if one provider can’t see you quickly, you may want to try another one, says the ALA. Some doctors set aside time in their schedule for emergencies that arise.
Consider their bedside manner. A big part of managing your COPD is learning how to use an inhaler, says Dr. Jani—and ideally, your doctor will be available to give you a demonstration. “Inhaler education is the number-one issue that we want to address with our patients,” he says. “If they’re not feeling better, we want to make sure they’re using their inhaler the right way.” Dr. Jani points out that not only do certain brands of inhalers work differently from each other, but many people with COPD may also struggle with hand-eye coordination and therefore need extra help learning to use their device.
Search for other specialists. Not all areas have a pulmonary rehabilitation program nearby, so you may have to travel to find one, says Dr. Jani. You can look for the closest one by visiting the American Association of Cardiovascular and Pulmonary Rehabilitation’s website and searching for a program by state and zip code.
Here Are the Doctors You May Want on Your Healthcare Team
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Primary Care Doctor
What they do: Your primary care doctor will likely manage your COPD, as well as be the point person for the rest of your care.
Why you’ll need them: A primary care doctor may diagnose you with a spirometry test, which measures how well your lungs work, and can prescribe medications to manage your symptoms, including short- and long-acting bronchodilators and corticosteroids. They can also coordinate your care with other specialists, if needed.
What to ask:
How can I prevent complications from COPD, and what preventative tests, if any, should I have?
What should I do if I experience a COPD exacerbation?
How do I use a rescue inhaler?
How can I reach you in an emergency?
Pulmonologist
What they do: These doctors are specialists in treating diseases that affect the respiratory system, including COPD.
Why you’ll need them: Pulmonologists tend to manage more severe cases of COPD. “People who are having frequent exacerbations once or twice a year, especially if they need to go to the hospital, may benefit from seeing a pulmonary specialist,” says Dr. Hersh. A pulmonologist can also prescribe medications such as short- and long-acting bronchodilators and corticosteroids.
What to ask:
How will you work with my primary care physician and other doctors to treat my COPD?
What tests do you want to perform, and what will the results indicate?
What should I do if I experience a COPD exacerbation?
Am I a candidate for surgery or clinical trials?
How do I use a rescue inhaler?
How can I reach you in an emergency?
Pulmonology Rehabilitation Specialists
What they do: These specialists consist of doctors, nurses, and respiratory therapists, among others, who can put together a program that will educate you about your symptoms, teach you breathing techniques, and provide supervised exercise classes.
Why you’ll need them: Because COPD can make breathing more difficult, pulmonary rehab specialists will teach you techniques such as pursed-lip breathing, among other strategies. They can also show you how to exercise safely and more effectively, as well as offer nutritional counseling. One scientific review found that pulmonary rehabilitation can help improve people’s quality of life, walking abilities, and shortness of breath. However, says Dr. Jani, many people will face a high copay for pulmonary rehabilitation with their health insurance.
What to ask:
What types of breathing exercises will you teach me, and how might these impact my COPD?
What type of exercise should I do, and how often?
Counselors, Psychologists, Psychiatrists
What they do: Mental-health specialists who can treat conditions such as anxiety and depression using talk therapy, or, in the case of a psychiatrist, prescription medication.
Why you’ll need them: Up to 33% of people with COPD have mental-health conditions, which can interfere with their ability to exercise or take medication. (Anxiety, in particular, may cause shortness of breath, which in turn makes it harder to breathe.) Some research has also found a link between anxiety and depression and an increased risk of exacerbations and COPD-related hospitalizations.
What to ask:
What types of coping strategies should I use to manage my stress, anxiety, or depression?
Am I a candidate for medication, and if so, how might it affect my COPD?
Nutritionist or Registered Dietitian
What they do: These professionals can help you develop an eating plan that will meet your health needs. Some have experience working with people who have chronic conditions, such as lung diseases.
Why you’ll need them: Nearly 10% of people with COPD are underweight, according to some research, possibly because their respiratory muscles can require up to 10 times more calories for breathing than those of someone without the condition. Not all macronutrients are created equal, though: Eating carbohydrates produces more carbon dioxide than protein and fat—and when carbon dioxide builds up in the body, it can lead to shortness of breath.
What to ask:
What types of foods should I include in my diet?
Are there any foods I should avoid?
How many calories should I eat in a day?
How often should I eat, and what portion sizes do you recommend?
Thoracic Surgeon
What they do: A thoracic surgeon can perform lung volume-reduction surgery (LVRS), a procedure that removes the areas of the lungs that are most damaged by COPD.
Why you’ll need them: If you have severe lung damage, your doctor may recommend you undergo LVRS, which can allow you to breathe better. Research shows that 69% of people who underwent the procedure experienced breathing-related improvements one year after the surgery. “Not every patient will qualify for it, but those who do get surgery feel a difference,” says Dr. Jani. The best candidates tend to be younger than 75 years old and haven’t smoked in at least six months, according to the ALA.
What to ask:
Am I a candidate for surgery?
Am I strong enough to undergo the surgery?
What are the benefits and drawbacks of this surgery?
What are the complications of this procedure, if any, and how can I avoid them?
What kind of results can I expect from the procedure?
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