Medical System Challenges

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When it comes to treating Fibromyalgia, patients frequently become frustrated with the medical system due to its lack of efficiency and effectiveness.  While often patient anger and disappointment is justified, frustration can be minimized by acknowledging and accepting certain facts related to both fibromyalgia and the medical system itself. Understanding and accepting the limitations of the medical system in relation to the specific challenges associated with effectively treating Fibromyalgia is a crucial first step in learning to take responsibility for leading your own individual treatment efforts.

Patients must understand and accept that fibromyalgia is a highly individualized condition. As such, its effective management often requires a team that consists of numerous specialists across a number of different disciplines (e.g., rheumatology, neurology, mental health, nutrition). It is unrealistic to assume that a single physician will be able to handle all of these needs for a patient, as it is impossible for one individual to be properly educated in all of the various specialties a fibromyalgia patient will need to include in their care. Because the healthcare system is highly fragmented, patients must understand that including all of these specialists in their care will require multiple doctor visits, coordinating various treatment plans, and facilitating communication between providers. These circumstances place a large burden on the patient to assume responsibility for the management and direction of their own care.  This is the reality of fibromyalgia and modern large scale healthcare systems, as well as the driving force behind the importance of self-management in fibromyalgia treatment.

Fibromyalgia patients may be met with skepticism by some doctors while trying to assemble their desired team of care providers, which can lead to ineffective symptom management and patient frustration. Although fibromyalgia has made great strides in the past few decades in terms of its recognition as a true clinical diagnosis and disease entity, misperceptions still abound and some providers continue to doubt that it is a legitimate diagnosis. For example, the fact that fibromyalgia has symptoms that overlap with those of numerous other conditions (such as chronic fatigue syndrome, irritable bowel syndrome, and others), often creates hurdles for the patient during the diagnostic process. If a particular physician is of the mindset that fibromyalgia is not a legitimate entity, he or she may forego a diagnosis of fibromyalgia in favor of another, more defined illness with similar symptoms. By doing so, this may inadvertently direct treatment efforts at a particular symptom or group of symptoms, and ignore the underlying fibromyalgia as a whole, which may lead to ineffective symptom management and frustration for the patient.

The chronic pain that fibromyalgia patients are forced to deal with often leads both patients and providers to immediately consult the use of medication. Although there are several medications approved by the US Food and Drug Administration for the treatment of fibromyalgia-related pain (including Savella, Cymbalta, and Lyrica), they are not universally effective for all patients, which often forces healthcare providers to resort to other options for pain management, such as antidepressant medications and others. In addition, narcotic (opiate) pain medications are frequently prescribed for fibromyalgia patients despite the lack of evidence suggesting their usefulness in treating fibromyalgia pain. The prescribing of these drugs for fibromyalgia pain may occur out of a physician’s frustration at their inability to help relieve their patients’ pain, or out of patient frustration for similar reasons. In addition, this can occur because a large number of physicians continue to lack an in-depth understanding of the nature of fibromyalgia as well as the most effective means of treating it. By falling back on the common practice of “throwing pills at it,” this treatment approach can often serve to make symptoms worse for the patient in the longer term.

Unfortunately, there are medical system limitations that make fibromyalgia treatment difficult for almost all patients, however they do not make it impossible. These examples all illustrate the importance of self-management in the treatment of fibromyalgia, which can help patients overcome the systemic limitations and more effectively manage their illness. Patients must become educated about the individualized nature and treatment of fibromyalgia, so as not to have unrealistic expectations from the outset. In addition, they must embrace the understanding that they are ultimately responsible for managing their own treatment, in close collaboration with their doctors. By doing so, fibromyalgia can be managed effectively and efficiently despite the limitations of the current medical system.

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