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When you're looking for a medical specialist, it's sometimes really difficult because you don't know who's good and who isn't. Sometimes you can rely on a friend or relative who's seen somebody' or you can call the local hospital because sometimes they'll give you the names of people who specialize.

Unfortunately, these methods are not necessarily the best ways to locate somebody who is really skilled.

I've written a previous article on how to find an arthritis expert' and that should be mandatory reading if you're looking for a top-notch person. (The 12 Things You Must Look For In An Arthritis Expert)

This new article will add a few other things.

Do you know what training an arthritis specialist (rheumatologist) has gone through? Let me tell you' Four years of college, four years of medical school, three to four years of internal medicine residency, and three years of fellowship in arthritis training. And several board exams have to be passed along the way culminating in the internal medicine boards and the rheumatology boards. Many candidates don't pass the first time around.

You should ask if they passed the first time or not. You can maybe excuse somebody for not passing once (although even that is a bit much) but if they have had to take the exams over and over, then you might want to be a bit leery. After all you don't want to see a doctor who's a few fries short of a Happy Meal!

This article will give you the essential things you need to look for in an arthritis specialist.

1. Graduate of an American medical school. American medical education is still the finest in the world.

2. Residency training at a University teaching hospital.

3. Fellowship training at a top university or better yet, a biomedical research center like the National Institutes of Health.

4. Reputation. What do you hear about the doctor from his or her patients?

5. Education. Is this specialist still doing research and continuing to publish papers' the best do.

6. How many papers published- 25-50 is a minimum.

7. How does their practice run? Is the staff courteous, efficient, and do they seem to know what they're doing?

8. Do the employees appear to enjoy their work? There's nothing worse than walking up to a receptionist or other staff person who treats you like a piece of chuck roast.

9. When you are in the office do the physician and the staff give you informational literature about your case? Do they answer your questions?

10. Do they return your calls the same day?

11. When you start a new medicine do they go over the things should look out for as far as side effects?

12. Do they refer tough cases out? Often, a doctor who has ego problems may not refer out a patient who should be referred out. An arthritis specialist can't be a specialist in all types of arthritis- there are too many of them. For instance, I am an expert in rheumatoid arthritis and osteoarthritis. While I can take care of patients with mild lupus, I refer out more serious cases because I don't really feel I have the expertise or the energy any longer to take care of these complicated patients' so I refer them to a University hospital.

13. Are they careful about checking laboratory tests regularly?

14. Is research being done? The best arthritis specialists do research. They have their hand on the pulse of what is happening in the forefront of their specialty.

15. Are they invited to speak nationally? Obviously, a person who is a nationally recognized speaker has the knowledge and respect to have earned this right.

16. Do they care? You can tell by how the doctor talks to you and follows up with you. Do they stay in touch? For instance, we send out a monthly newsletter to keep patients informed, entertained, and in touch.

17. Are they trustworthy? In your heart of hearts, do you feel they have your best interest at heart?

18. Are they cheap or are they expensive? Doctors who sign up with insurance plans are weak and usually second rate. The best arthritis experts don't sign insurance contracts because they don't want to work for the insurance company. They want to work for the patient and do what's right for them. Not surprisingly, they also are expensive because they are the best. Remember' in life you get what you pay for.

Let's face it' picking the right doctor isn't like looking for laundry detergent. This is particularly true when it comes to arthritis, many forms of which can lead to crippling disability as well as early death.

The right arthritis expert can make the difference between your leading a long, productive, and enjoyable life' or dealing with a progressive, crippling, agonizingly painful existence.

Like Yogi Berra once said, 'When you come to a fork in the road, take it''

It's your life and your health that's on the line.