TY - JOUR T1 - Dr. Harrington replies JF - The Journal of Rheumatology JO - J Rheumatol SP - 853 LP - 853 DO - 10.3899/jrheum.080944 VL - 36 IS - 4 AU - J.T. HARRINGTON Y1 - 2009/04/01 UR - http://www.jrheum.org/content/36/4/853.1.abstract N2 - The information provided by Dr. Bernatsky and colleagues in response to Graydon and Thompson’s report1 and my accompanying editorial2 is appreciated. Their observation that patients may delay seeking medical care for early rheumatoid arthritis (RA) relates to a different problem than we were addressing: the ineffective evaluations and delays in referral by providers once the patient is seen. Like all stakeholders in healthcare, physicians typically deflect responsibility for problems from themselves onto others3–5. So the use of focus groups to explore provider attitudes is unlikely to yield helpful data regarding the root causes of health system underperformance. Moreover, the resistance of patients from rural areas and lesser financial circumstances to specialty consultation should not be generalized. Dr. … ER -