Association of physicians’ illness perception of fibromyalgia with frustration and resistance to accepting patients: a cross-sectional study.
233 Rheumatologists, in Japan, with a history of treating Fibromyalgia patients were evaluated via multiple questionnaires about their perception of patients with Fibromyalgia. A past study showed that doctors viewed Fibromyalgia patients as significantly more difficult than patients with RA. A Spanish study showed that physicians perceived Fibromyalgia to be primarily Psychological in nature, and hard to control. This study examined the question of why doctors are reluctant to treat Fibromyalgia patients.
The Good News: Just over 44% said they would welcome more Fibromyalgia patients. While most expressed a hesitation to accept new Fibromyalgia patients, it was not because they perceive us as “difficult patients” but because they feel inadequate at helping us.
The Bad News: The primary reasons that the 55+% of doctors who would not see FM patients their prime reasons for not doing so were (in order)
1. It would be better for them to see a Fibromyalgia specialist (good answer) – 19.5%
2. It’s a Psychiatric disorder (WTF!) – 14.4%
3. It takes too much time – 14.1
4. Too many are “difficult” – 13.5%
5. Not confident in the treatment – 12.9%
6. Doubtful that FM is real – 12.9%
Yeah, that last one is a doozy isn’t it? It’s good that they would rather not see us, because we’d rather not see them.
The doctors expressed frustration at the inability to control symptoms, and patients emotional responses. Their biggest issue taking new patients was the inability / difficulty of controlling the patients symptoms through treatment. Another issue that affected doctors frustration level was “causal attribution” or what the patient (or doctor) believed was the cause of the illness.
Another point of the study was the doctors who consider the primary cause of Fibromyalgia to be “patient internal/psychological factors” have the most difficult relationships with their patients. Conversely, those doctors who felt that Fibromyalgia was caused by external / medical factors had a much easier relationship with their patients. Doctors also have a more difficult relationship patients who have a history of Psychological disorders.
The good news for us as patients is that we can know that if a doctor has issues with us, it’s not about us, it’s about their perception of our illness. Therefore, it’s important that we find a doctor who has a positive view of Fibromyalgia and does not view it something Psychological.
Homma, M., Ishikawa, H., Kiuchi, T. (2014). Association of physicians’ illness perception of fibromyalgia with frustration and resistance to accepting patients: a cross-sectional study. Clinical Rheumatology.