Cultivating the Patient-Provider Relationship during Fibromyalgia Syndrome

the delivery of quality health care requires a sound working relationship between patient and provider, but it can be difficult to achieve, even in the best circumstances. Differences in treatment goals, expectations, time constraints and education form a significant barrier to effective patient-provider communication. It is important in any situation, this relationship is especially critical when treatment is poorly understood, difficult to diagnose and relatively controlled conditions as fibromyalgia syndrome.

Patients and doctors are often too personally vested in their role to identify these potential pitfalls, and the result is awkward and unsatisfactory encounter for both patient and provider. To understand how this happens, it is constructive to look at differences in how each party understands the sometimes contentious relationship.

Fibromyalgia patients often require two things when they first visit a doctor. They want someone to listen and understand, and they want to feel better. Reasonable desire, certainly, but not without the potential to create problems, either.

As modern people, we have been conditioned to think our doctors because our auto mechanic. When something breaks we have to diagnose, repair, and continue as before, and it's actually a pretty good analogy, most of the time. If we get a respiratory infection, we got it diagnosed, take our antibiotics, and one week a metaphorical our engines are running smoothly as ever.

This is the expectation of many fibromyalgia patients to make their first visit to the office ... and it is probably very different from the approach taken to their doctor. Of course, doctors are fans of auto-mechanic analogy, too. Given their choice, would probably choose to see patients with undefined, structural disease that can be cured with a high probability of success. Unfortunately, fibromyalgia syndrome does not fit into that model. The fact that fibromyalgia symptoms are so varied and pain, so just a generalized treatment for medical problems.

services tend to be wary any time a patient presents with idiopathic pain. Legal and ethical responsibilities require the services prescribed painkillers for medicinal purposes, and subjective pain with no identifiable cause is a favorite trick for individuals attempting to illegally diverting drugs. It is sad for the suffering of patients who have fibromyalgia syndrome is on the way, leaving doctors immediately faced with a dilemma, especially when the patient is unknown.

This is not intended as an indictment against a doctor or training. On the contrary, this cautious approach is exactly what one should expect from a competent physician. Suffering fibromyalgia patients is not likely that this idea first and foremost in their minds, though.

By the time they get to the doctor's office, the majority of fibromyalgia patients are already dealt with a barrage of skepticism about their invisible illness. Spouses, employers, friends and associates are likely to have expressed some level of disbelief about their condition at some point, and it is natural for fibromyalgia patients eventually assume a defensive attitude about their health. In combination with your professional skepticism, the defense sets the stage for a potential patient-provider conflicts.

Even if these initial difficulties were overcome, the nature of fibromyalgia creates other problems. The lack of quantifiable testing leaves a diagnosis of fibromyalgia is open for discussion, and incorrect diagnosis of fibromyalgia is relatively common. Medically unexplained physical symptoms and dysfunction are common complaints in primary care settings, and the difference in the assessment of these symptoms can be a challenge to create a relationship between providers and patients. (1)

Patient reaction to the diagnosis of fibromyalgia syndrome can vary in line with expectations, but it is often follows a predictable pattern that can act to undermine the doctor's treatment plan. (2) typical first reaction was one of denial. As explained earlier, most fibromyalgia patients are expected to determine which diseases can be adequately controlled, if not completely cured. diagnosis of fibromyalgia syndrome usually offered either one of these desired outcomes.

Even if the diagnosis is accepted, patients still tend to seek other opinions, both medical and nonmedical, in an attempt to find a suitable outcome. Many times this is done without a doctor's diagnosis of knowledge and May lead to failure of prescribed therapy, which serves to further undermine the patient-provider relationship. Doctors tend to see these actions as subversive and May get to see their fibromyalgia patients as difficult, demanding or disease focused. (3) As a result of these paragraphs, patients can have their pain and frustration of a deduction from the health services.

These tensions tend to be self-reinforcing as patients become frustrated with the excessive testing, bad treats symptoms, and condescending attitude. Health care services can begin to spend less time with patients (viewing them as having unrealistically high expectations), or come to see her primarily as a psychosomatic illness. (4.5) Obviously, this situation does nothing to improve patient outcomes, and leaves the patient and provider and emotionally drained.

The good news is that solutions to this problem have been identified, but they require a commitment of both patients and providers to be effective. Joint decision, in which the patient has an active role in selecting appropriate therapy, showed that both qualitative and quantitative differences in patient outcomes. (6) Including family members in treatment plan also aims to improve how to improve.

"One size fits all" therapy does not work well in the treatment of fibromyalgia syndrome, and an interdisciplinary approach often achieves better results. (2) providers who consult with allied health team members report better results and less stress when the patient interaction treating fibromyalgia patients.

First of all, the successful treatment of fibromyalgia requires a hopeful attitude of the patient. Patience, encouragement and motivation are therefore necessary components of any treatment plan. Cultivation of this cooperative partnership in the early treatment helps avoid many pitfalls that can eventually poison the patient provider relationship.

1 Fitzcharles MA, Boulos P. inaccuracy in the diagnosis of fibromyalgia syndrome: analysis of referrals. Rheumatology 2003 February;. 42 (2) :263-7.
2nd Alghalyini B. It is a bad feeling: the patient-physician dialogue about the rescue of patients from fibromyalgia culture. Can Fam Physician 2008 November;. 54 (11) :1576-7.
3rd Asbring P, Närvänen AL. Ideally, in relation to reality: physicians perspectives in patients with chronic fatigue syndrome (CFS) and fibromyalgia. . Soc Sci Med 2003 Aug; 57 (4) :711-20.
4th Stutts LA, Robinson ME, McCulloch RC, Bano E, Waxenberg LB, Gremillion HA, Staude R. Patient-centered outcome criteria for successful treatment of facial pain and fibromyalgia. J Orofac Pain 2009 Winter;. 23 (1) :47-53.
5th Robinson ME, Brown JL, George SZ, Edwards PS, Atchison JW, Hirsh AT, Waxenberg LB, Wittmer V, Filling RB. Multidimensional success criteria and expectations for the treatment of chronic pain: the patient perspective. Bol Med 2005 September-October,. 6 (5) :336-45.
6th Bieber C, Müller KG, Blumenstiel K, Schneider, Richter, Wilke S, Hartmann M, Eich W. long term effects of joint decision-making intervention on physician-patient interaction and outcome in fibromyalgia. qualitative and quantitative 1 years follow-up randomized controlled study. . Patient Couns EDUC 2006 November;. 63 (3) :357-66