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When you have a major event like a blood clot, the medical system can sometimes feel overwhelming. What type of doctor should you see? How can you find the specialists that you need?
Your primary care provider coordinates your care
Your primary care provider, or PCP, is the person that you see for annual wellness visits and other routine care. Your primary care team—which may include doctors, nurse practitioners, physician assistants, medical assistants, and office staff—plays a few different roles in your care, one of which is to coordinate your care when you have a complex medical situation. Your PCP is like the quarterback of your care team.
Your PCP will determine which specialists you should see, provide referrals if necessary, and keep an eye on reports from different specialists. Your primary care team will help ensure that nothing falls through the cracks and that the recommended treatments from various specialists work well together. Your PCP will also oversee your medications and make sure that none of them interact with one other.
You may have seen your PCP when you first felt the symptoms of a blood clot – but if you got care for your blood clot in an emergency room (ER), urgent care clinic, or hospital, your PCP should be notified.
You should also see your PCP a few days after you get home from the ER or hospital.
Specialists involved in blood clot care
After a blood clot, your medical care may involve one or more medical specialists (doctors or healthcare professionals who specialize in a certain type of medicine). There are several types of specialists who may be involved in your care after a blood clot.
The specialist you need will depend on the specifics of your medical situation. For example, your treatment will be different if your blood clot occurred in a vein versus an artery.
Here are some of the specialists that you might end up seeing after your clot:
A vascular surgeon or interventional radiologist
Interventional radiologists (IR) are specialists that use imaging, such as x-rays or CT scans, to perform certain medical procedures. For example, imaging can help an IR guide tools like catheters through a person’s blood vessels.
You may need an open surgical procedure to remove a blood clot from a vein or artery. In these cases, a vascular surgeon will open the affected blood vessel, remove the clot, and then repair the vessel.
A clot can also be removed or dissolved through a less invasive procedure in which a catheter is inserted through the skin into a blood vessel. The catheter is then threaded to the site of the clot and the clot can be physically removed – or medications can be delivered directly to the clot to dissolve it. These procedures may be performed by a vascular surgeon or interventional radiologist. Not all clots are treated using one of these procedures; in some cases, medications alone are used.
If you require a procedure, your care team will outline your options and carefully explain why the procedure is recommended.
Hematologists specialize in treating diseases of the blood. Blood clots and clotting disorders are blood-related conditions, so you may see a hematologist as part of your care. A hematologist will often order tests to determine what’s causing your clots and will help you choose the right treatment to lower your risk of having another clot.
If you take a blood thinner, you may be asked to follow up with your hematologist regularly. Many medical systems also have anticoagulation clinics staffed by trained pharmacists. If you’re taking a blood thinner like warfarin, then you may visit the anticoagulation clinic regularly for testing and dose adjustments, rather than going to your hematologist. Your PCP might also be responsible for managing your blood thinners.
A pulmonologist specializes in diseases of the lungs and other parts of the respiratory system. If you’ve experienced a pulmonary embolism (PE) and develop lung-related complications, you may need to see a pulmonologist to help manage these issues.
A cardiologist specializes in treating diseases of the heart and other parts of the cardiovascular system. In certain situations, you might need to see a cardiologist after having a blood clot. For example, some abnormal heart rhythms cause blood to pool in the heart and therefore raise the risk of a clot. Treating these abnormal rhythms can help reduce the risk of a blood clot.
You may also need to see a cardiologist if a clot formed in a coronary artery (meaning that you had a heart attack), or if a blood clot in your lungs damaged your heart.
If your blood clot is thought to be caused or worsened by an underlying condition, you may need to see a different specialist entirely. For example, an endocrinologist specializes in treating hormonal conditions. If you have an autoimmune condition (in which your immune system is attacking your own tissues), you may need to see a rheumatologist.
How to find a physician that specializes in vascular care
In most cases, you won’t need to do the work of finding specialists on your own. You’ll usually get referrals from your PCP, or from your care team at the hospital or ED. The healthcare professionals in your community will generally be able to provide you with the best referrals because they have experience with lots of different specialists.
There may be situations where you’re looking for a new specialist. For example, you might be unhappy with the care that you’ve received from a doctor and prefer to switch to a different one. In most cases, the best approach is to ask your PCP for a new referral.
If you’re ever searching for a specialist on your own, it’s best to look for a doctor who’s board certified in that specialty. The American Board of Medical Specialties has a website where you can search for a doctor’s name and verify that they have board certification. You can try asking family and friends if they’ve had good experiences with a healthcare professional; however, personal or “word-of-mouth” recommendations can be a hit-or-miss approach since every patient’s needs are different.
- If you have symptoms like redness, swelling, or pain in your arms or legs, make an appointment with your PCP right away. If you’re experiencing chest pain, difficulty breathing, a rapid heartbeat, lightheadedness or sudden weakness, numbness, or difficulty speaking, go to the ER as soon as possible. Treating clots early is critical to prevent serious complications.
- If you’ve been treated in the hospital or ER for your blood clot, make an appointment to see your PCP a few days later. Your primary care team will help to coordinate your care.
- Ask your PCP or your care team at the hospital for referrals to the specialists that you need. Talk with them about why they’re recommending certain specialists for you. Don’t be afraid to ask for more information.
- Contact your PCP if you have any questions about your care plan.
- Be sure to stick with your recommended care plan. You may need medications to prevent future blood clots; make sure that you take those as directed for as long as your doctor prescribes them. Many people need these meds for 3 to 12 months after a clot, and some people need them for life. If compression stockings are recommended, wear them as directed.
*Originally published in The Beat — February 2023. Read the full newsletter here.