Doctors don’t hear out migraine patients
Treatment of migraines leaves a lot to be desired and in part not because we do not have effective treatment, but because of a communication barrier. Doctors appear not to want to hear what migraine patients have to say about their headaches, according to a remarkable study by a top headache researcher Richard Lipton and his colleagues. Patients and doctors agreed to be videotaped during a visit and 60 such interactions were analyzed. The analysis showed that doctors did not ask about the disability of headaches and tended to ask closed-end short questions. Very often the information they did obtain was incorrect. 55% of doctor-patient pairs were misaligned regarding frequency of attacks; 51% on the degree of impairment. Of the 20 (33%) patients who were preventive medication candidates, 80% did not receive it and 50% of their visits lacked discussion of prevention. The authors recommended that doctors assess impairment using open-ended questions in combination with what is called the ask-tell-ask technique.
I agree – it helps if a doctor has migraines. When I gave a lecture to a group of six neurologists only one of them used Imitrex and similar drugs as the first choice, while others often started with ibuprofen. That one neurologist was the only one who suffered from migraines.
I do get them and feel that I can relate better to my patients’ experience. Fortunately mine are infrequent and Imitrex tablets or injections work well.
I have seen several doctors for migraines because I have moved around quite a bit lately (not good for migraines!), but I have always hoped to find a doctor that personally has them. I finally found one (by chance), and I feel that the line of communication is better than ever. He truly understands what I am going through. I’m sorry he has them, but at the same time I’m happy I found someone who does.