General practitioners' perceptions of chronic fatigue syndrome and beliefs about its management, compared with irritable bowel syndrome: qualitative study
Sadly it will have come as little surprise to many sufferers of
ME/CFS that unless GP’s have had first hand experience of ME/CFS
patients often experience a poor level of understanding of this illness
in the doctors’ surgery.
It must though be open to question whether GP’s themselves are
entirely to blame for this situation. Information being disseminated
appears to be poor, GP’s seem to be fed on a “diet” of papers and
articles with a psychiatric "accent" by the mainstream medical journals
and the diagnostic criteria now appears to be so nebulous that they may
find it difficult to differentiate ME from other fatigue states.
Fortunately as an ME sufferer my own experience has been somewhat
more positive as my GP is keen to be updated on the latest biomedical
research findings from organisations such as MERGE and others committed to
unravelling the physical causes of ME/CFS (as detailed by Douglas
Fraser). The “Canadian Criteria” (1) for ME/CFS also seems to have been
well received at our local surgery - it would seem that to date nothing as
comprehensive has been produced here in the UK.
Having eventually lost my career due to ME/CFS last year and the
means to support my family I find that references to "low symptom
thresholds", "poor work ethic" and "secondary gain" not only alarming but
quite frankly, pathetic. Everybody that I know who suffers from this
wretched illness is desperate to resume a normal life again and regain
some degree of autonomy and financial independence.
Unfortunately Dr Barrington Johnson's comments are also
particularly unhelpful and I am left wondering quite what illness he is
referring to when talking collectively (and I feel a little
contemptuously) of "these patients". Given that Kennedy et al (2) recently
demonstrated the inclusive nature of the 1994 Fukuda criteria it is
extremely disappointing that we still have health service professionals
advocating a “one size fits all” approach. He also talks about ME/CFS as
"this game" and regrettably that is precisely what it has become, as
those who should know better continue to play games with other peoples
lives.
Finally I am far from clear why Rosalind Raine and her colleagues
were comparing GP's attitudes between ME/CFS and IBS at all. Surely it
would have been more logical to compare GP’s attitudes to the management
of ME/CFS with other neurological illnesses such as MS ?
Duncan Cox
1. ME/CFS: Clinical Working Case Definition, Diagnostic and Treatment
Protocols.
Journal of Chronic Fatigue Syndrome, 2003, 11, 7 - 116.
2. Kennedy et al. Specficity of CDC criteria for CFS. Annals of
Epedimiology. Feb 2004.
Rapid Response:
GP's can be better informed
Sadly it will have come as little surprise to many sufferers of
ME/CFS that unless GP’s have had first hand experience of ME/CFS
patients often experience a poor level of understanding of this illness
in the doctors’ surgery.
It must though be open to question whether GP’s themselves are
entirely to blame for this situation. Information being disseminated
appears to be poor, GP’s seem to be fed on a “diet” of papers and
articles with a psychiatric "accent" by the mainstream medical journals
and the diagnostic criteria now appears to be so nebulous that they may
find it difficult to differentiate ME from other fatigue states.
Fortunately as an ME sufferer my own experience has been somewhat
more positive as my GP is keen to be updated on the latest biomedical
research findings from organisations such as MERGE and others committed to
unravelling the physical causes of ME/CFS (as detailed by Douglas
Fraser). The “Canadian Criteria” (1) for ME/CFS also seems to have been
well received at our local surgery - it would seem that to date nothing as
comprehensive has been produced here in the UK.
Having eventually lost my career due to ME/CFS last year and the
means to support my family I find that references to "low symptom
thresholds", "poor work ethic" and "secondary gain" not only alarming but
quite frankly, pathetic. Everybody that I know who suffers from this
wretched illness is desperate to resume a normal life again and regain
some degree of autonomy and financial independence.
Unfortunately Dr Barrington Johnson's comments are also
particularly unhelpful and I am left wondering quite what illness he is
referring to when talking collectively (and I feel a little
contemptuously) of "these patients". Given that Kennedy et al (2) recently
demonstrated the inclusive nature of the 1994 Fukuda criteria it is
extremely disappointing that we still have health service professionals
advocating a “one size fits all” approach. He also talks about ME/CFS as
"this game" and regrettably that is precisely what it has become, as
those who should know better continue to play games with other peoples
lives.
Finally I am far from clear why Rosalind Raine and her colleagues
were comparing GP's attitudes between ME/CFS and IBS at all. Surely it
would have been more logical to compare GP’s attitudes to the management
of ME/CFS with other neurological illnesses such as MS ?
Duncan Cox
1. ME/CFS: Clinical Working Case Definition, Diagnostic and Treatment
Protocols.
Journal of Chronic Fatigue Syndrome, 2003, 11, 7 - 116.
2. Kennedy et al. Specficity of CDC criteria for CFS. Annals of
Epedimiology. Feb 2004.
Competing interests:
None declared
Competing interests: No competing interests