What types of doctors diagnose and treat COPD (chronic obstructive pulmonary disease)?

Your “regular” doctor or general practitioner may make the diagnosis and provide the care you need. When necessary, you may also be referred to a medical specialist (a doctor with advanced training) for further evaluation. These specialists include:

• Pulmonologists (who are also internists), who specialize in caring for people with lung and other respiratory diseases
  Internists, doctors who specialize in caring for adults and may also have advanced training in pulmonary disease
• Your primary care provider (PCP, “regular” doctor) may be an internist.
• Thoracic surgeons (also called cardiothoracic surgeons), who perform surgical diagnostic and treatment procedures inside the chest (thorax).
• For a person with suspected COPD, a thoracic surgeon may do an open biopsy (removal of a small amount of lung tissue for laboratory analysis).
• Someone with severe COPD may be referred to a thoracic surgeon for lung surgery.
• Psychiatrists and psychologists
• A psychiatrist is a doctor who specializes in the diagnosis and treatment of mental disorders.
• A psychologist is not a medical doctor but typically holds an advanced degree in an area of mental and/or emotional health.
• A person with COPD who is trying to stop smoking may see a psychiatrist or psychologist for help with depression or anxiety.

What particular things can a specialist [pulmonologist] do to help with managing my COPD (chronic obstructive pulmonary disease)?

A pulmonologist can make important contributions to managing your COPD when:

• Your “regular” doctor wants to be certain about the diagnosis
• You are age 50 or younger and either have never smoked or have smoked only a short time
• You have symptoms not usually due to COPD
• You have one or more additional diseases that have similar symptoms
• You’ve been going to the hospital often with sudden shortness of breath
• You need long-term corticosteroid or oxygen therapy
• You may need lung surgery

Additional advantages of seeing a pulmonologist include the possibility that he or she:

Will have COPD information to give you, such as:

• Printed materials-for example lists of commonly used COPD medications
• Suggestions for lifestyle changes that have benefited other people with COPD
• If you think you should see a pulmonologist, you can ask your “regular” doctor for a referral. You can also make your own choice -just be sure to let your “regular” doctor know.

Why do doctors use the name COPD (chronic obstructive pulmonary disease)? Why don’t they just use the names of the different diseases grouped under this term?

“Chronic obstructive pulmonary disease,” or COPD, is the name doctors give to a pair of diseases-chronic bronchitis and emphysema-that:

• Make it difficult to exhale (empty the lungs during breathing)
• Often occur together in a single person

The COPD “mix” may differ:

• Some people with COPD have more emphysema symptoms, while others have more symptoms of chronic bronchitis.
• Asthma is not usually grouped under the name COPD, but people with asthma may develop COPD over time.

COPD causes:

• Airflow blockage (chronic bronchitis)
• Difficulty breathing (emphysema)
• Chronic bronchitis is characterized by inflamed, mucus-filled, narrowed airways that make it harder to breathe.
• Emphysema is characterized by loss of the lungs’ ability to stretch out and back during breathing. This limits how much air they can hold and causes shortness of breath.

Besides shortness of breath (which typically worsens during exercise), the most common COPD symptoms include:

• A chronic (long-term) cough
• Coughing up mucus

COPD is almost always caused by lung damage due to years of smoking, as are chronic bronchitis and emphysema.

COPD is both preventable and treatable. If you are having breathing problems, and particularly if you smoke or have been exposed to cigarette smoke over time, consider asking your doctor to evaluate your risk of COPD.