Criteria For A Good Fibro Doctor

Discussion in 'Fibromyalgia Main Forum' started by COOKIEMONSTER, Jun 26, 2003.



    Criteria For A Good Fibromyalgia Doctor
    Compiled and with an introduction by Tamara Liller, M.A.

    It is frequently difficult for persons with fibromyalgia to find a physician who is both experienced in FM diagnosis and treatment and willing to take the time to listen. In addition, it is often challenging for the physician to determine whether a new symptom experienced by a patient is some new manifestation of fibromyalgia or a warning of some other, potentially dangerous malady. Dr. Romano offers interesting insights:

    It's important to go to somebody who knows what he's doing. Very important! Doctors are punished for practicing medicine, so good luck! If you find somebody, stick with him, work with him. If you have a disagreement, work it out. If a doctor is willing to see you, willing to work with you, is open-minded and reads the stuff from the internet that you bring in, if he is willing to be your partner in therapy, send him a present at Christmas, give him a kiss, hug him--he needs it!

    It's hard to take care of you, by the way. Very hard. The practitioner has to overcome a lot of problems. One perpetuating factor is the environment in which all this treatment takes place. Furthermore, fibromyalgia can mimic other causes of pain. Just because you have FM, you can't blame everything on it.

    For example, here is an absolutely true story. I went to see a patient of mine who was admitted to the hospital to have an emergency appendectomy. She had been having pain for a week or so before the operation. Her appendix burst; she became hypotensive; she almost died. So I asked her why it took her so long to get to the hospital. She said: Because it hurt like everything else hurt. Interesting!

    You could have other stuff, so don't blame everything on FM. Please be aware that your chest pain may be fibromyalgia; it may not be. You have to get this stuff checked out!

    I don't know if you realize this, but doctors are taught how to make mistakes. Of course, they don't want to make mistakes, but if they're going to make them, there's a way to do it. There are two kinds of mistakes that can be made: a Type 1 or Alpha error or a Type 2 or Beta error (these are statistical terms).

    A Type 1-Alpha error means you assume something is present, but it's not. An example: chest pain. You go to the emergency room. They strap you down, put a heart monitor on you, put an IV in you, give you nitro under the tongue, and they assume it's a heart attack. It's important that they assume it's a heart attack because if it's a heart attack, you could die. So they monitor you, admit you to the hospital, and two days later, the doctor comes in and says: Luckily it wasn't your heart, it's something else. It could be indigestion; it could be musculoskeletal, whatever. But that stuff isn't going to kill you. So it's important that doctors make Alpha errors. We check and make sure you don't have the worst thing, and then we can always take our time figuring out what's really going on.

    The Beta errors, which we don't want to make, assume something is not there, but it is. An example of a Beta error...Do you know an actress by the name of Heather O'Rourke? Did you ever see Poltergeist? She was the little blonde girl who says, 'They're here!' Well, she's dead. She died because of a Beta error. Her mother took her to the ER, and the doctor diagnosed her as having the flu or something. Well, she ended up having a perforated viscus. I don't know whether it was appendix or some other part of the intestine, but it perforated, and she died.

    When I learned medicine, we were told that if you have abdominal pain, you should be admitted for observation unless you know the reason for it. If it's a kidney stone, or if it's stuff that you've had before, and you pretty much know the pattern, that's fine. But if you have really bad abdominal pain, you should be observed. If not there can be Beta errors, and Beta errors can be fatal!

  2. kredca4

    kredca4 New Member

    This is such a Timely article, I am having to change Doctor's and what a battle it is with them.

    I have printed this out to help them to Understand me, and FMS/CMP.

    The Doctor who has been treating me the longest for the FMS/CMP, is a Surgeon, not a Primary, my HMO say's that I have to see a PC.

    I agree, mainly because my Orthopedic Dr. is super busy, he has a lot of pt's, but they are there for Surgical procuder's or for a Consulaton because another PC sent them there. He's the Best in his Field, so he get's lot's of Reffeerals.
    He shouldn't have to be seeing me, for a Condition, that has, as yet, no Cure.

    The only defense is to be dilligent in keeping track of our symptoms, noting when something is new, and then checking out the Problem with the Dr. or Er, to make sure it's not a Lifethreatning condition and not FMS.

    I think this article say's it better than what I could ever write. I talk ok, one on one, cause I look people in the eye, and I seem to find word's ok, at least the spoken word dosen't fail me as much as trying to write it out.

    Anyway thanks again, this "Hit's the Nail On The Head" as my grandmother used to say.
  3. kredca4

    kredca4 New Member

    good article. Thanks again.