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- Page navigation anchor for RE: Response to Dr. BeckerRE: Response to Dr. Becker
Dear Dr. Becker, thank you for taking the time to read about my experience. I can assure you that the migraine community in Canada is very grateful for your work and research in this field. I have turned my frustration and pain into advocacy and support for others so some good has come from this experience. My experience is not unusual. While I think that a great deal of pressure is placed on physicians to solve problems, after living with chronic migraine for several years I can assure you I had absolutely no expectations that a physician would take my pain away. My greatest hope was to see a marginal reduction in my pain, a tiny improvement in my quality of life. My point is simply that there is an ethical issue with telling a patient there is no hope for them. Many of us are extremely educated about our disease, but as you say, it’s incredibly complex and each patient is different. It requires a huge amount of tenacity on the part of both the patient and physician. All I ask is for a partnership: for a patient to have the agency to disagree with a physician without the fear of being “fired” as a patient, and without the fear of misleading notes in our patient files. We don’t expect miracles but a partnership would be fair. I completely agree that a multidisciplinary approach is necessary, especially given the high rate of comorbid conditions which often exacerbate the complexity of treatment. I truly hope we can get there some day — it is my mission.
Competing Interests: None declared.References
- . 2023;:-.
- Page navigation anchor for RE: A patient’s perspective on finding treatment for migraine and a provider who believed herRE: A patient’s perspective on finding treatment for migraine and a provider who believed her
Thank you for sharing this story. The picture you paint of some of the physicians that you consulted is not all that flattering, but unfortunately too often true. Part of the problem may be that refractory migraine is difficult to treat and the treatments available don't help everyone. Physicians, especially those who don't know the migraine field well, often feel helpless, and this results in negative reactions on their part. After all, are not physicians supposed to be omnipotent? I am not making excuses for them. I hold to the view that patients should always come away from a physician encounter feeling they have had a positive experience, even if the physician could not help them. However, physicians are only human too.
As a headache specialist for 25 years, I have come to recognize that difficult migraine is a very complex problem, and complex problems usually don't have simple solutions. In our system, physicians often don't have the time to fully deal with the complex solutions required. In my opinion, we need more multidisciplinary teams working in headache care in Canada. Teams can often address problems that are very difficult for individuals to solve. The patient is usually the most important member of such teams.Competing Interests: None declared.References
- . 2023;:-.