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A woman talking with her doctor

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

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.

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.

We are more than migraine

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?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.


  • sarahblankenship
    11 months ago

    I have spent a lot of years searching for relief of chronic migraine. I have seen so many different doctors with varying degrees of success. The neuro I see now is probably the best doctor/patient collaboration I have had. She really listens and works with me to try to find a solution. She keeps up on recent studies and offers solutions besides just meds. She suggested acupuncture at my first visit because some studies show it can help, and it is safe. She gives me as much time as we need for each appointment and encourages me to email her in between if necessary. We don’t have a solution yet, although my first Aimovig dose helped ease symptoms some for the first 3 weeks. If you can’t work with your doctor, and you can do it, it’s worth trying to change. I asked for recommendations on FB from my migrainer friends and medical staff friends then talked to my primary.
    I have become quite the expert on migraines and symptoms. It helped, I think, that I walked into the neuro office with a detailed headache journal, a list of symptoms with proper names (aphasia, aura, etc…), and list of past failed treatments. It saved a lot of time and repeat treatments.

  • Holly Harding Baddour moderator author
    10 months ago

    Hi @sarahblankenship– Thank you so much for joining the conversation and for sharing such great guidance on the topic of finding a good fit in a migraine specialist. I like that you mention that you don’t have a solution ‘yet’. I’m hoping that the CGRP’s have a significant impact on the frequency of your attacks- please let us know.

    For many of us, there is no “solution” to be had. So, it’s more about managing pain and related symptoms. Your ideas are incredibly helpful and knowledgeable about what’s been tried, what has worked, what hasn’t, with a solid detailed disease history.

    It can be a journey to find a good fit and the “right” physician to partner along with us for such a complicated condition. Again, grateful that you shared some of your tips for getting there.

  • Ellen H
    11 months ago

    My fear is What happens to me when my doctor retires??? Will the new doctor believe me when I tell him/her that we’ve tried everything and nothing works and most medications leave me with miserable side effects? It’s scary.

  • Holly Harding Baddour moderator author
    10 months ago

    This is such a common concern among those in the migraine community. I’m glad you articulated it. Although I touch upon it in the this article, and community member @pooh-bear below, speaks to it, I think I will pose this as a specific question in an upcoming video to ask for our community to give us their guidance, ideas, and feedback on the subject. Keep your eyes out for said video and thanks for the idea!

  • Pooh-Bear
    11 months ago

    I am there now, sort of. My psych MD retired/forced out by Kaiser b’cuz of her RX’s. She was a psycho-pharmacologist. She knew her drugs better than anyone I’ve met. Now my primary has cut me off of the one drug that works for me. (Fiorocet) Neurologist same, only she gave me topamax (anti-seizure) which is horrid! I am also a chronic pain sufferer on morphine. When the doc says the gov’t made me do it, I just don’t believe that. So what do you do when you’ve been on a drug that works for 10+ yrs and now can’t get a refill. This opioid crisis has made life hard for me a true sufferer. So, my fear is your fear. I am researching options of appealing Dr’s decision. With Medicare and esp. Kaiser hope is fading. Ellen, do not ever give up! YOU are the expert on you. God Bless………

  • Holly Harding Baddour moderator author
    9 months ago

    @pooh-bear and @rellenh – I just wanted to follow up with you both as I told you I’d try tackling the issue of doctor retirement with a future article. I did so and wanted to provide the link here:

    There is some good discussion in the comment section following the article you might check out if you have the time.

    I hope you both will chime in on that piece regarding your own journey’s and ideas.

    So glad you’re a part of our community. Please stay in touch.

  • Ellen H
    9 months ago

    Hi, Pooh Bear, Have you found a new doctor yet for your migraine struggles? I am searching right now for a new Primary Care/ OBGYN. It feels like I am floating in free space and not connected anywhere. I wish you good luck with your struggles and searches. Thank you for your kind words. — Ellen H.

  • Holly Harding Baddour moderator author
    10 months ago

    Hey Pooh- So glad you chimed in. This is a gigantic fear for so many of us (that of our long-time migraine specialist retiring). Such a good point you raise that even when that DOES happen – and we end up being disasteringly passed about from doctor to doctor, trying to justify where we’ve landed with our treatment approach- we must remain strong in the knowledge that no one is more of an expert on us, than we are!

    On the points you raised regarding the frustration related to accessing opioids in the current climate, I wanted to share with you a couple of articles on the same topic, in case you might be interested:

    Suffice it to say, you are NOT alone in this either.

    Again, grateful your shared your wisdom. Please keep coming back and doing so in order for us to learn more from one another!

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