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When to See a Pulmonary Specialist

when to see a pulmonary specialistIf you have COPD, you may be wondering when to see a pulmonary specialist. Because a pulmonary specialist, or pulmonologist, specializes in diseases of the lungs and bronchial tubes, adding one to your repertoire of health care providers is something you may want to consider. But should you consult with a pulmonary specialist at the onset of your symptoms? Or should you wait to see a pulmonary specialist after you’re diagnosed?

What is a Pulmonologist?

A pulmonologist is a medical doctor that has specialized knowledge and skill in the diagnosis and treatment of conditions and diseases of the lungs. Pulmonology is considered a subspecialty of internal medicine. In order for a physician to become a pulmonologist, they must have graduated from an approved medical school. They must have completed an internal medicine residency program which takes a minimum of 3 years in which they will have treated patients with a wide range of illnesses and medical conditions. They must then take and pass a certification examination administered by the Board of Internal Medicine. But this is not all. In the final stages of their training, they must complete a 2-year minimum pulmonary fellowship, during which time they will learn the symptoms and treatment of minor and major respiratory conditions from asthma, pneumonia and tuberculosis to COPD, interstitial lung disease and cystic fibrosis. At the end of the fellowship, the pulmonologist must pass a second set of board certification examinations in their specialty.

The Role of the Primary Care Provider in COPD

Although there are many different specialists that can make up a COPD treatment team, as long as your COPD is uncomplicated, most of your treatment can come from your primary care provider. Primary care providers play a critical role in the screening, diagnosis and treatment of COPD. They are usually the ones who end up catching COPD early, even before symptoms begin, by screening smokers using a simple breathing test known as spirometry.

Your primary care provider can also prescribe all of your COPD medications for you, including inhalers, steroids, oxygen and antibiotics. So if your primary care provider can treat your COPD effectively, when should you see a pulmonary specialist?

The Role of the Pulmonologist in COPD

Seeing a pulmonologist may be necessary if you have a more complicated case of COPD. For example, your primary care provider may refer you to a pulmonologist if you’re not responding well to COPD treatment, you’re hospitalized for COPD exacerbation or your disease has reached a more advanced stage of COPD.

A pulmonologist may order a different combination of medications or special treatments for you. To better-assess your condition or implement diagnostic studies, they can also perform a bronchoscopy using a flexible scope to look down your airway and inside your lungs. A pulmonologist may also have a staff that is very much geared for the lung patient that a primary care provider may not have or be able to afford in their office. A pulmonologist may also be used to reinforce what the primary care provider has already initiated, especially the importance of smoking cessation in a patient who continues to smoke.

What if I Can’t Get a Referral to a Pulmonologist?

You don’t have to wait for your primary care provider to refer you to a pulmonary specialist. If you feel you need one, you can self-refer, if you have PPO insurance, or you can request a referral from your primary care provider. If your primary care provider doesn’t want to give you a referral, speak to your health insurance company as it is within your rights to see a specialist if you have reason to believe you need one.

 

By Deborah Leader RN, BSN, PHN

 

52 thoughts on “When to See a Pulmonary Specialist”

  1. William Croft says:

    Can my primary care doctor write the prescription for a oxygen concentrator or do I have to have lung specialist do that?

    1. Inogen Inogen says:

      Hi William, If your primary care doctor determines that you need oxygen, he or she will be able to prescribe you oxygen therapy. If you have any additional questions about portable oxygen concentrators, please call an Inogen Oxygen Specialist at 1-800-678-5572.

  2. William (Bill) Barnes says:

    I have COPD and have been on oxygen for nearly 2 years. I have recently started coughing and my back hurts along my lungs. I have not called my primary dr. yet, because I can refer myself and would like to see a specialist. What would you suggest? I am on an inhaler, ANORA,

    1. Inogen Inogen says:

      Hi Bill, We encourage you to see a pulmonologist so that they can diagnosis your symptoms.

  3. Sammy says:

    I was diagnosis with mild COPD. I have had a cough for 2 years this Nov. I was diagnosis with acute reflux two years ago. On the chest x-ray they also found a Hiatal Hernia. Do the two work hand in hand. Do I need to see a Pulmonologist?

    1. Inogen Inogen says:

      Hi Sammy, Since we are not your primary care doctor we cannot give you medical advice. We recommend that you consult with your primary care doctor so that he or she can refer you to a pulmonologist if needed.

  4. rae says:

    I have been to my primary and have had pneumonia 2 times this year and cannot get rid of a cough. I have a needling pressure on the left side that doesn't go away – like a ache. Not asking for medical advise, just whether a pulmonologist is the right direction to go.

    1. Inogen Inogen says:

      Hi Rae, If you have had a cough for more than three weeks, it is defined as a chronic cough. If you are experiencing a chronic cough, you should see a pulmonologist. However, please first consult with your primary care doctor. He or she can diagnosis your symptoms and refer you to a pulmonolgoist if needed.

  5. Ron says:

    I have been diagnos with copd may 15 2016 and diagnos with chf my heart doctor told me that my sleep apnea doctor can take care of it is that true

    1. Inogen Inogen says:

      Hi Ron, It couldn't hurt to talk to the doctor. I suggest you call their office and speak to them and determine if that might be helpful. Good luck and best wishes.

  6. Hope Abey says:

    (My english is not so good)

    A friend of mine, he has cough problem. He is suffering from cough problem for 20 years now. There is no pain in lungs or in any body part, no blood during cough nothing just cough.. (except mucus) .He had visited alots of hospital n Doctors n almost all doc. said its just a allergy . But the prescribed medicine doesnt work much. He still has the problem.
    Few weeks back he visited a doc n he suggested him some medicinal herbs. It seems its working a bit but not all.

    please will you suggest some measures to be taken for him to recover like foods and medicine for allergy..

    1. Inogen Inogen says:

      Hi Hope, We have a few blog posts about allergies/respiratory symptoms. For foods that may worsen respiratory symptoms, please visit: https://www.inogen.com/blog/foods-may-worsen-respiratory-symptoms/
      For 10 tips on how to relieve winter allergies, please visit: https://www.inogen.com/blog/10-tips-taming-winter-allergies/
      For 8 ways on how to rid your home of allergies, please visit: https://www.inogen.com/blog/8-ways-to-rid-your-home-of-allergens/
      We hope this helps you and your friend! Happy holidays.

  7. altha says:

    I was diagnosis with COPD will be three years this April 2018, just recently started coughing. I have a problem with loseing weight but eat like a country dog can someone help me tell me something please.

    1. Inogen Inogen says:

      Hi Altha, Many COPD patients experience weight lose and find it harder to maintain their weight. For more information on COPD, specifically on COPD diets and exercise, please visit: https://www.inogen.com/resources/living-with-copd/copd-fact-sheet/

  8. Debra says:

    I have always been sensitive to chemical orders (perfumes included) causing coughing, and mucus to develop. Now that I'm older, this sensitivity is worse. At times, I feel tightness in my chest and more mucus than usual. This stays with me for 3-4 after exposure. I've told my primary and asked about using an inhaler, but she says go to hospital. I'm not critical, so should I see a Pulmonary Specialist, instead?

    1. Inogen Inogen says:

      Hi Debra, If your primary care doctor says you should go to the hospital, you should go to the hospital.

  9. Ana says:

    I have had a cough since November and still have it. My primary doctor has given me symbcort (I think its spelled wrong). But, the cough has not gone away. I never had this before. I don't know what is causing this. I have had antibiotics and bacterial medicine. They did x-rays but nothing shows. I have seen my primary more than 3 times, still the same medicine, should I consult with a lung specialist?

    1. Inogen Inogen says:

      Hi Ana, It sounds like you have been experiencing a cough for about 4 months and you haven't experienced any relief from your symptoms. You should bring this up to your primary care doctor and ask him or her to refer you to a specialist.

  10. Lesley Trafford says:

    I have had a mold/formaldehyde issue in my body for a few years…took me nearly 3 years to figure out what it was. I am now having issues with the house being closed up for the summer and the AC unit being used instead of fresh air. It is tightening my chest, making me light headed and hurting my throat and nose… any ideas what to do about this. The unit is relatively new and has the new 'freon'… I didn't have this trouble with the old freon. Can you give any advise please. I am now very sensitive to formaldehyde, raw wood and chemical smells… I am like a' canary down a mine' and can smell things that others cannot.

    1. Inogen Inogen says:

      Hi Lesley, It sounds like you have a mold/formaldehyde issue in your house. To improve the air quality in your home, the CDC recommends that people do not smoke indoors, that they try to open windows as much as possible, fix water leaks to help keep mold away, and to clean away any mold you see or smell with detergent and water.

      For more tips, please visit: https://www.cdc.gov/nceh/drywall/docs/whatyoushouldknowaboutformaldehyde.pdf

  11. glenda phillips says:

    hi, i have been treated for copd for over a year by a nurse practisioner no xrays have been done of my lungs how do they know i have copd. she told me at tne beginning she did not know if i had the emphysema part now that i ask for a lung dr she told me i had the emphysema along with chronic broncatis.which this puzzles me how do they know without xrays she only listen to my lungs each visit

    1. Inogen Inogen says:

      Hi Glenda, Has your doctor conducted a spirometry test? A spirometry test is required to confirm a diagnosis of COPD. Additionally, there are a few other studies that support a COPD diagnosis. For more information, please visit: https://www.inogen.com/blog/how-is-copd-diagnosed/

  12. Pete says:

    This is probably a stupid comment but…….. I had some shortness of breath issues over the last couple months but they seem to be resolved. I have had PET scan and seen a cardiologist and things seem to be coming along well. I am back to running five miles every day with no problem and am working my way back up to six miles. My primary care doc has referred me to a pulmonologist. I am thinking all things considered I don't need to see one. Opinion ???

    1. Inogen Inogen says:

      Hi Pete, We recommend you follow your primary care doctor's recommendations as he or she is more familiar with your medical history. Although you may feel fine right now, most respiratory diseases are progressive meaning they get worse over time. You may feel relief from your symptoms now but down the line your symptoms could return and could be worse because you didn't treat your symptoms when they first appeared.

  13. Lisa says:

    I have had a bad cough that is disrupting my life at work and at home. Been to 3 ears, eyes and nose specialist and tried various antibiotics, etc. They have not seen anything and wants to refer me to a Pulmonologist. Have been to Mayo Hospital for tests, my primary care for tests, allergy tested, at my wits end. How could a Pulmonologist help me with this problem?

    1. Inogen Inogen says:

      Hi Lisa, Has your doctor done any respiratory tests? If not, ask your primary care doctor he or she thinks a chest x-ray is necessary. Usually, a chest x-ray is usually one of the first things your doctor will order if you’re experiencing difficulty breathing. For more information about chest x-rays and other tests that are used to diagnosis breathing problems, please visit: https://www.inogen.com/blog/tests-for-diagnosing-breathing-problems/

  14. Bev says:

    How can I find a pulmonary doctor in the Memphis area who has knowledge of the treatment of bronchial casts? I understand that they are fairly rare in adults. I have also lost my voice so I can't speak on the phone any more. My voice comes back a little but people say they can't understand me. I think I have reached the point where I need someone to assist me with getting the care I need, especially since I am a shut-in, disabled due to PTSD with no family or friends to help. Any light you can shed on how to proceed would be greatly appreciated.

    1. Inogen Inogen says:

      Hi Bev, Does your insurance provider have a website or a directory where you can look up doctors by their specialty? If so, that may be a good place to start especially if you want to stay in-network. You can also go to your primary care doctor and ask him or her to refer you to a specialist with experience in bronchial casts. We hope this helps!

  15. Corne says:

    i need help , i have done an x-ray , but my doctor cant seem to find anything on the x-ray , but i keep feeling in the morning very dizzy , and i do have this shortness of breath , which cant seem to be explained , and my hands feel like it swells up a bit with the feeling of that i havent breathed or took enough oxygen in my sleep , my docter never even mentioned that you get people like you, what should i do , does it seem to have any relation to this?

    1. Inogen Inogen says:

      Hi Corne, Although a chest x-ray can be effective, there are a few other tests that a Pulmonologist could do. For more information the the different types of pulmonary function tests, please visit: https://www.inogen.com/blog/pulmonary-function-tests/

  16. Marie Hicks says:

    My sister has been diagnosed with chemical lungs. They said it was like she walked in a burning building and inhaled all the toxins she can barley breath. I am wondering if she needs to go to a Dr. in Houston. She was in a Houston hospital for 4 days and sent home with antibiotics. She has been in this hospital for 3 days. Had x-rays and cat scans.

    1. Inogen Inogen says:

      Hi Marie, By "chemical lungs" do you mean "chemical pneumonitis"? Regardless if you are your sister's power of attorney, please work with your sister's primary care doctor to determine whether or not it is time for your sister to see a Pulmonary Specialist.

  17. Deborah says:

    My primary care doctor found out today that I have a very small amount of fluid in the lower right lung, and has suggested I contact a cardiologist. Shouldn't I be seen by a pulmonary doctor instead of a cardiologist? I have shortness of breath, and very fatigued, and is all I can do to wash dishes every day.

    1. Inogen Inogen says:

      Hi Deborah, That does sound odd but since we are not your primary care doctor and we are not familiar with your health history, it's hard to say whether or not you should see a Pulmonologist. Your primary care doctor may want you to see a Cardiologist before seeing a Pulmonologist for a variety of reasons and you should follow his or her guidance as your primary care doctor is most familiar with your health.

  18. Rich Lucero says:

    HELLO,

    I AM SCARED TO SEE A LUNG DOCTOR. I DO NOT HAVE SHORTNESS OF BREATHE OR A CHRONIC COUGH. I DO HAVE SENSATIONS INSIDE MY CHEST AND WHAT FEELS LIKE A SLIGHT PAIN WHEN TAKING A DEEP BREATHE. I ALSO WAKE UP THROUGH OUT THE NIGHT WITH A RACING HEART AT TIMES. I HAVE BEEN TO 6 DOCTORS WHO SAY I AM IN GOOD HEALTH. I HAVE HAD 3 EKG'S, AND EKG STRESS TEST, A QUICK ECO AND BLOOD WORK COMPLETED. TWO XRAYS AS WELL THAT CAME BACK UNREMARKABLE. ALL AT THE BEGINNING OF MY SYMPTOMS OF A RACING HEART. THEY ALL SAY IT'S ANXIETY. DO YOU SEE ANY NEED TO BE SEEN BY A PULMONOLOGIST?

    1. Inogen Inogen says:

      Hi Rich, We understand that seeing health professionals, such as a pulmonologist can feel scary or intimidating. However if you're experiencing negative symptoms, it's important to work with your primary care doctor to determine the cause of your symptoms. Please consult your primary care doctor to determine whether or not seeing a Pulmonary Specialist or another specialist, like a Cardiologist.

  19. Diana says:

    I have COPD, I went to see a pulmonary specialist, I went through tests and my lungs are at 50%, after seeing him twice in 3 months he told me that I didn't have to see him anymore, at the time I was happy and gave him a big hug. Then I start thinking and asked myself why, will I be dying soon, my sister has asthma and sees her doctor every year, she's been going for 20 years for a check up. When I called my specialist he told me I could go and see him at anytime, I thought like my sister, her doctor tells his secretary to make her an appointment a year ahead of time, It really worries me that my doctor said that to me, he gave me Zenhale and Speriva and an emergency inhaler to carry with me at all times, he didn't mention if there are breathing exercise I can do, I have to research and that scares me, sometimes it's things I don't want to read. Everyone is different. What should I do, find another specialist?

    1. Inogen Inogen says:

      Hi Diana, Please consult your primary care doctor as he or she is familiar with your health history and will be able to provide you with the best advice. Your primary care doctor may or may not recommend that you seek a secondary opinion.

  20. Donna says:

    Hi, I have had some type of respiratory issues going on for about 6 months. I seen my primary care doctor for this and he basically listened to my lungs and had me breathe in and out. he said everything sounded good. it is hard to explain. the best way I can describe it is, it feels like I always have a cold or some type of irritation. I have a slight cough but nothing that is alarming. I don't feel short of breath . my chest feels a little tight. my throat doesn't hurt but feels irritated. I am not coughing up anything. I do have a runny nose from time to time. I have this anxiety that I have a tumor or something very serious.

  21. Rich Lucero says:

    Thank you for writing me back. Yes its scary I'm 38 with 4 kids. I don't want to hear I have 3 years to live if I have some sort of lung disease. Their doesn't seem to be a lot of hope out there for this. I am losing weight unintentionally now and can only sleep through the night if heavily medicated.

  22. shelia kidd says:

    I had pneumonia diagnosed with GP back in early August. I have taken 5 treatments of prednisone, used a nebulizer, cough syrup, Antibiotic injections, steroid injections and now on symbicort and Spirva respimat (started 9/18/18). I still have chest discomfort constantly. Should I get a referral to see a specialist or wait and see if this last round of meds will make a difference.?

    1. Inogen Inogen says:

      Hi Shelia, Please work with your primary care doctor as he or she is most familiar with your medical history.

  23. Melodie Wallace says:

    I had a low dose lung CT and it showed I had emphysema (2 years in a row). My doctor called with the results but said nothing about the emphysema. When I asked about it he said “you probably do have it”. I asked about treatment and he said “quit smoking, but you did that 12 years ago so you’re good”. Should I talk to another doctor or continue to do nothing. I have some shortness of breath and wheezing but it isn’t severe yet.

    1. Inogen Inogen says:

      Hi Melodie,
      It is always a good idea to get a second opinion. If you are experiencing shortness of breath and wheezing, I would urge you to look into it sooner rather than later. Have a great day!

  24. Rich Lucero says:

    Saw my lung doc. Had Chest CT low dose with contrast came back negative and the following spirometer results. Do you see any concerns and is there other test I should follow up with? I am still having minor chest discomfort and back pains. She also reviewed a chest x ray taken at a Chiro office a few weeks later and it was good. SPO2 in high 90's

    FVC 5.75/5.70 99%

    FEV1 4.70/4.53 96%

    FEV1/FVC 82/80 96%

    FEF 25-75% (L/SEC) 4.8/4.15 86%

    Expiratory Time 7.52

    FEFMAX 11.25/15 133%

    MVV 178/172 96%

    Lung Volumes

    SVC 98%

    TLC 98%

    RV Pleth L 91%

    RV/TLC 92%

    ERV 103%

    TGV 102%

    Airways Resitance

    RAW 1.45/.96 66%- Lowest number?

    GAW 101%

    SGAW 111%

    Diffusion

    DLCOunc 102%

    DLCOcor 101%

    VAL 103%

    DL/VA 97%

    1. Inogen Inogen says:

      Dear Rich, Thank you for communicating with us. We cannot offer any medical advice regarding your testing. I suggest you ask a pulmonary specialist if there are any additional tests you should undergo and present the Dr. with your test results. Best of luck and health!

  25. Debbie says:

    I have a chronic cough. I have to cough after I eat – I have acid reflux and now take Nexium every day and that has helped mitigate the after-eating cough. However, I cough at all points of the day and often have difficulty "getting the cough out". I feel I need to cough and when I do, it's productive but there are a lot of false starts. Do I need to see a pulmonologist or should I start with my primary doctor?

    1. Inogen Inogen says:

      Hi Debbie,
      I would suggest you start with your primary care doctor and then you can get a referral to a pulmonologist. HMO insurances usually require this.
      I hope you feel better soon!

  26. Rich Lucero says:

    Could a CT of the chest using a 128 slice 3mm approach detect small airway disease? Should it pick up on an diseases of the interstitial?

    1. Inogen Inogen says:

      Dear Rich,
      Please contact a radiologist with this question, as this would be the responsibility of a Radiologist (MD) to read the results of a CT scan. We wish you well.

  27. RIchard Lucero says:

    One more question for now. when I talk it seems as if I run out of breathe and my voice vibrates stronger into my chest. Any advice?

    1. Inogen Inogen says:

      Hi Richard,
      I suggest you speak to a pulmonary specialist and have them evaluate this condition.

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