How I practice: Rheumatologist finds a calling and a highly rewarding specialty

Christopher Parker, DO, might practice taekwondo techniques in his free time, but by day his focus is working as chief of rheumatology at Austin Diagnostic Clinic in Austin, Texas.

In 1994, while serving in the U.S. army, Dr. Parker graduated at the top of his class at the University of Health Sciences-College of Osteopathic Medicine, now Kansas City University of Medicine and Biosciences. He moved on to residency at William Beaumont Army Medical Center, where he was awarded most outstanding resident, and then a rheumatology fellowship at Walter Reed Army Medical Center.

Dr. Parker is also a lifelong athlete who is a national record holder in the squat lift and a Collegiate All-American in powerlifting.  He earned the army’s “Physical Fitness Excellence” badge and, in 2016, his black belt in taekwondo.

The DO spoke with Dr. Parker about his professional choices. This is an edited transcript.

What initially drew you to osteopathic medicine?

Medicine for me was a calling. I knew early in the game and deep down that it was something I wanted to do.  I interviewed at allopathic and osteopathic schools and immediately just knew the DO path was right for me. I graduated from medical school as valedictorian and was in the army at the time.

What made you decide on rheumatology as a specialty?

I knew I wasn’t a surgeon. I’m not designed for that. I started on the path to internal medicine and when I looked at the rheumatologists, I loved the two that I knew. I saw that their patients adored them because they’re helping them feel better with a chronic illness. Also, it looked to me like the rheumatologists themselves loved their jobs. They weren’t up all night, tired, dealing with emergencies and delivering babies. They had a good quality of life.

What makes rheumatology stand out from the crowd of specialties?

I noticed early on that a rheumatologist’s diagnosis was rarely questioned by other specialists. They have control of their domain and they don’t have to limit themselves to one system of the body. Rheumatologists have very well-rounded medical knowledge. They know every system of the body, with a multi-organ, big picture perspective, like DOs, and I thought that was magnificent.

Is rheumatology rewarding?

A lot of people ask me if my job is a downer because people come in with complaints all day. But it’s really the exact opposite, I think, because I help people manage those symptoms and feel better.

There’s no surgery. You don’t have to be up all night delivering babies or fixing someone’s heart, but we get to deal with organ-threatening or vision-threatening illness in a clinical setting. The treatment is mostly outpatient, which is great.

What qualities do you think are essential for being a good rheumatologist?

Young docs who might be interested in rheumatology need to be the kid that can deal with uncertainty pretty well. We can’t see the immune system. We’re still learning the basic anatomy of the immune system. It’s super complicated and we’re totally in our infancy of understanding it. They should be comfortable with not being exactly sure with how lupus starts, for example, and totally willing to take their time to pick through the medical history of the patient.

They also have to like being adept at understanding not just a single organ but how to examine and work with all of the organs and all the other specialists as they’re caring for their patients.

When and how do you incorporate the osteopathic approach into your practice?

When I’m looking for someone’s underlying rheumatic illness, I always step back,  look at the big picture and ask ‘what other things can I look at to make this person’s life healthier?’ Things like teaching them the importance of diet, exercise, sleep, and positive relationships. If someone starts thinking that’s not going to affect their arthritis or RA (rheumatoid arthritis), they’re wrong. You can watch their disease improve when they focus on these lifestyle factors.

Other doctors I’ve worked with think it takes too much time to get an in-depth medical history, but I’m open to it because you can’t fix it if you don’t know about it. Anxiety, depression, sexual issues—we can fix all these things, but we first need to know about them. So you have to prompt the patient and open the door. Otherwise it’s always repressed.

In what setting do you work? What is a typical day like for you?

Austin Diagnostic Clinic is a large, multi-specialty group. There are five rheumatologists and 110 physicians total. It’s a great place to practice. If you like working and collaborating in a group, which I do, it’s a beautiful thing.

I typically see my first patient at 7 a.m. and I leave the clinic by 5 or 5:30 p.m. I have a half hour to eat if I don’t have to see a patient during that time. And by the end of the day, I often get many hugs because patients are grateful for the improvement in their quality of life. That’s very rewarding.