The puzzles and patient care opportunities inherent in rheumatology sparked a passion in Maya Estephan, MD, during her internal medicine residency rotation at the Arthritis and Rheumatology Clinics of Kansas (ARCK).
Five years later, Dr. Estephan has returned to ARCK’s Wichita clinic to practice alongside ARCK’s physicians, including Timothy Shaver, MD, FACP, whose passion for rheumatology played a huge role in Dr. Estephan’s final career selection.
“I did my rotation with Dr. Shaver as an intern and realized rheumatology is what I wanted to do,” Dr. Estephan says.
The care of the whole person, opportunities to build long-lasting relationships with patients and the challenging nature of the discipline were a good fit for Dr. Estephan’s compassionate approach to care and healing.
“People are so appreciative, and you feel you are making a difference,” she says. “You help them, and they appreciate that and you feel better about what you are doing.”
Treatment of the chronic illnesses common to rheumatology requires a long-term approach, and Dr. Estephan says it is important to her to build a relationship with her patients as she works to ensure their conditions don’t worsen or become debilitating.
“It is true that these are chronic diagnoses, so when someone starts to see a rheumatologist, they have to see them for years,” Dr. Estephan says. “In chronic diseases, even when they go into remission, we need to monitor them. But this is an advantage to us because we build a relationship with those patients. They trust us.”
Dr. Estephan says this trust is important because rheumatology is an art in which the same treatment might work for one patient and not for another.
“You get a more patient-specific approach because there’s always a challenge to the diagnosis,” she says.
Making the diagnosis and finding the most effective treatment are part of the joy of the job for Dr. Estephan, who says she particularly enjoys diagnosing and controlling conditions such as scleroderma and vasculitis, which often can be missed or misdiagnosed.
Options and opportunities
Dr. Estephan says even though her patients’ diagnoses are difficult, rheumatologists have more treatment options at their disposal than ever before.
“This is a very exciting time in rheumatology,” she says. “In the past 20 years we have had so many new drugs within rheumatology, and in the past five or six years it has just been booming.”
Once she visits with a patient and evaluates that individual’s lab work, Dr. Estephan designs treatment plans with the goal of keeping the patient as healthy and active as possible.
“I like to be proactive, and I prefer to control the disease before it becomes debilitating,” she says. “We have good drugs. We just need to see the patient and find the drug that is appropriate for that individual.”
However, she cautions that the drugs are powerful and do impact patients’ immune systems, and she feels the weight of responsibility when helping patients select treatment options.
“The choice comes as an agreement with the patient. We tell them, ‘These are the side effects and these are the benefits. Are you willing to take that drug?’” Dr. Estephan says. “They usually ask me, ‘What if I were one of your family members? What would you choose?’”
She takes the question very seriously.
“This could be my mom or my dad or my brother, sister, kids, aunt,” Dr. Estephan says, adding this is the framework through which she views her recommendations. “They ask your opinion and they do value your opinion. They put you in charge, and you feel the responsibility to take care of them.”
To schedule an appointment with Dr. Estephan or one of the Wichita ARCK physicians, please call 316-612-4815. For more information about ARCK’s Wichita or Olathe clinics, please visit arck.org.