November 13, 2019

Finding the Right Fibromyalgia Doctor

I recently ran across an interesting article on a blog published by the North Carolina disability law firm Hardison & Associates called “Fibromyalgia: Searching for the Right Doctor.”   This article raises several issues that I regularly face in my own disability practice – many physicians do not understand how to diagnose fibromyalgia and can damage your disability case by offhand comments in your medical record.

Some doctors incorrectly see fibromyalgia as a “garbage can” diagnosis, meaning that any pain symptoms that cannot otherwise be explained end up with the fibro label.  The problem with this approach is that Social Security judges are increasingly familiar with the American College of Rheumatology’s diagnostic classifications for the disease and judges will discount or ignore a physician diagnosis that does not refer to the American College diagnostic criteria.

Some doctors – thankfully fewer and fewer – do not accept that fibromyalgia exists at all.  Often the medical records from these doctors will contain suggestions that the patient has psychiatric problems, or worse, that the patient is a malingerer or drug seeker.The Hardison law post quotes from a National Fibromyalgia Association publication that offers the following questions that a fibro patient should ask his doctor:

  • Are you comfortable with diagnosing and treating fibromyalgia?
  • How many fibromyalgia patients have you treated?
  • Are you familiar with my other conditions?
  • What medications do you usually prescribe for fibromyalgia? Do you have a problem with the medications I am currently taking?
  • What do you feel is adequate pain control?
  • Can you treat depression or must I see a specialist?
  • Are you familiar with alternatives therapies? What therapies do you recommend?
  • How can you and I communicate best?

In this era of soaring medical costs and lower reimbursements, patients must serve as their own advocates.  Changes in health care law will discourage treatment of conditions that cannot be objectively observed on x-rays or MRI scans.   Fibromyalgia patients will therefore need to assert the legitimacy of their condition and their rights to treatment.

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