The Complexities of the Migraine Doctor/Patient Relationship
The relationship between a migraine doctor and patient may span decades and can be a game-changer in the life of a migraineur. Let’s face it: life with migraine is hard. It’s important to remember that our doctors are human too and their jobs are hard as well. Many dynamics are at play when patient and doctor meet and it can help to be mindful of what might be going on under the surface.
Power differential between doctor and patient
A common and unfortunate dynamic between doctor and patient may involve a power differential in which the doctor holds all the cards and the patient is left feeling voiceless. The reality is that these doctors hold the key to our ability to access new treatments, help us navigate ever-changing health insurance challenges, prescribe us the preventative and rescue medication on which we depend, help us avoid trips to the emergency department by creating sound strategies to avoid that outcome, and, if needed, establish a claim for disability. Suffice it to say, these doctors DO indeed have a great amount of power.
Is your input and experience valued?
That said, migraine patients have lived with the disease for many years and have great insight when it comes to which medications and strategies work best. A physician who values his or her training above our lived experiences may not be most effective. It helps to think about whether your doctor values your input and experience and reflect on the power dynamic between you and your provider.
Treating migraine holistically
If specifically trained in migraine medicine, there’s a better chance that a migraine specialist will treat holistically and encourage the obtainment of healthy and regular sleep, diet, and exercise goals. When we fall short of these goals, a specialist is more likely to be understanding and nonjudgmental. They also evaluate whether we have adequate emotional support and will refer us to support groups and/or therapists when needed.
Doctors are human, too
As patients, it is important for us to remember that doctors are human, too. They can be tired, or frazzled, or frustrated, just like us. The pressures of their practice, health insurance red tape and their own personal lives can impact their work. The field of migraine medicine must be an incredibly challenging, draining, and heavy one. With no cure, the day of a migraine doctor is full of listening to people talk about being in severe pain. Again, if we are asking them to see us as human, we should offer them the same courtesy.
Listening is a two way street
Finally, it’s helpful to make sure we remain open to hearing about new approaches and treatments as the field evolves. If they’re doing their jobs, migraine specialists remain current on cutting edge research and should be eager to introduce these strategies to us. It is understandable if we get entrenched and hold tight to our medications, especially if it took years to find something that worked, even if only a little. However, if we want our doctors to listen to and value our wisdom and experience, we need to do the same for them.
There’s a lot going on when we visit our migraine doctors. We may be in pain, upset, anxious, or full of questions. Being mindful of the multi-faceted dynamics at play in the patient-doctor relationship may help reduce anxiety and so that we may have a better chance of achieving our collective goals.
Does your doctor value your input? Listen to your ideas about your care? Or simply refill prescriptions and shuffle you out of the room? If the latter, is it something you are comfortable discussing with your physician? If your appointments are short and rushed, it is worth pointing out to your physician. What can you do to shift the dynamic?
How much has your migraine disease changed or evolved over time?