A Working Partnership

Having a doctor with whom we have a good working partnership is very important for us when we have been diagnosed with a chronic illness and are trying to put our life back together after the diagnosis. It seems that patients are most satisfied with partnerships rather than authoritarian control by the doctor because partnerships allow us to participate more in healthcare choices, leading to more informed decision making, better follow through and adherence to the treatment plan, and ultimately better health and quality of life[i].

The type of relationship we need with a doctor is different under different circumstances, and our needs are influenced by personality characteristics, culture and can vary with the severity of symptoms and illness. But our reality when we are attempting to get the symptoms of  a chronic illness under control is that we will need to spend more time attending to our health care needs and this requires maintaining a good working partnership with a doctor. With the help from a doctor who we trust, our symptoms are more likely to improve, we are more likely to regain functioning, and will be able to sort out what activities from our old life we are able to keep or resume, which ones we can keep but in a modified form, and which ones we will let go of.

 The excellent working partnership that I had with the family doctor who helped me get control of my fibromyalgia symptoms was an important factor in my learning how to manage FM symptoms, regaining a sense of who I am, and gaining a sense of normalcy that is allowing me to thrive. Finding a doctor I could work with didn’t happen purely by chance or totally by divine intervention. Before I developed fibromyalgia, I needed a general practitioner and visited several that I never went back to. Some of them did a good job of treating the medical problem for which I made the appointment, but I just didn’t feel right about how the doctor related to me.

 When I left my first appointment with the doctor I finally chose, I had the impression that he was competent, listened well, and showed an interest in me as a whole person, not just some symptoms. When I started developing symptoms of muscle weakness, muscle pain and fatigue he took them seriously and made referrals to specialist that resulted in a very thorough and thoughtful assessment but not a diagnosis. During this process he was responsive, genuinely concerned, and caring.

I decided to go to the Mayo Clinic, with the support of my doctor, to see if they could identify why I had gotten so sick so quickly. Additional testing had the same results but the doctors at the Mayo Clinic gave me the diagnosis of Fibromyalgia. The fact that I received the diagnosis there and went through their Fibromyalgia educational program seemed to give legitimacy to the diagnosis. Their Fibromyalgia Clinic also provided recommendations for treatment that I took home and these provided a starting point for my doctor as we worked together to decrease symptoms and increase my functioning. Fibromyalgia is very difficult to treat, however, and we had to work hard to maintain our relationship.

 My relationship with my primary care physician didn’t begin to feel complicated until I was faced with symptoms that doctors couldn’t diagnose and then with a chronic illness that not much was known about. Some early experiences in life made it difficult for me to trust that doctors would hear my complaints of pain and respond with caring and compassion. I wasn’t hostile towards doctors – I just didn’t trust them to hear me and take care of me. I found that as my need for help with health care increased, my anxiety over asking for help escalated. I realized that I needed my doctor in a way that I had never needed a doctor before and I needed to learn how to relate to him in a way that involved trust. 

Comment from Dr. Taylor: A barrier to having a good partnership is that Fibromyalgia is a gut-wrenching problem for the patient and a daunting one for doctors.

Developing a relationship built on trust requires something from both individuals in a relationship so I have prepared a series of posts about the characteristics that we need in our doctor and also what we, as patients, need to take to the relationship. I write from what I have learned through years of reading and personal experience and I hope that my writing will stimulate your thinking so you will identify what is important for you in a good doctor/patient relationship. I am now looking for a new doctor and am amazed at how hard it is because even though I know what I need, each doctor has a unique style and personality and it takes time to discover compatibility.  I need a doctor who believes FM is real and can tolerate the frustrations of treating something s/he can’t heal. I wouldn’t agree to marry someone on a first date and I’m finding I don’t want to commit to working on a relationship with a doctor after one visit. The doctor/patient relationship is a lot like a marriage in that each relationship is unique because of the combining of two unique personalities.

 As I write these posts I will be sharing what my previous doctor taught me about how to work together, including his comments in the sidebars. I had originally written these posts as a chapter to be published in a book and he read and commented on that material.

[1] DiMatteo, R. (2004). Doctor-patient communication. In N. B. Anderson, Encyclopedia of Health & Behavior (pp. 261-265). Thousand Oaks, CA: Sage Publications.

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