Improving the prognosis of SLE without prescribing lupus drugs and the primary care paradox.

The outcome, quality of life and prognosis of lupus patients can be enhanced with close follow up and coordination between the individual's primary care physician and rheumatologist. Rheumatologists usually do not act as primary care physicians and leave health care maintenance to practitioners who need to be reminded to screen for various co-morbidities associated with inflammation and complications of medication. Rheumatologists need to take the responsibility to ensure that their lupus patients have optimal primary care access which includes a working relationship with them.