(excerpts and references -- go to ImmuneSupport to read the whole thing)
A question that is often raised by patients is “Why doesn’t my doctor know all of this?” The reason is that the overwhelming majority (all but a few percent) of physicians ... do not read medical journals. When asked, most doctors will claim that they routinely read medical journals, but this has been shown not to be the case.
There has been significant concern by health care organizations and experts that physicians are failing to learn of new information presented in medical journals and lack the ability to translate that information into treatments for their patients. The concern is essentially that doctors erroneously rely on what they have previously been taught and don’t change treatment philosophies as new information becomes available.
William Shankle, MD, Professor, University of California, Irvine ... “Doctors do not seek to implement new treatments that are supported in the literature or change treatments that are not."2
The Annals of Internal Medicine found that ... the longer a physician is in practice, the more inappropriate and substandard the care.6
In response to this unacceptable lag, an amendment to the Business and Professions Code, relating to healing arts, was passed. This amendment, CA Assembly Bill 592; An act to amend Section 2234.1 of the Business and Professions Code, relating to healing arts, states, “Since the National Institute of Medicine has reported that it can take up to 17 years for a new best practice to reach the average physician and surgeon, it is prudent to give attention to new developments not only in general medical care but in the actual treatment of specific diseases, particularly those that are not yet broadly recognized [such as the concept of tissue hypothyroidism, Chronic Fatigue Syndrome, and Fibromyalgia]...”9
a study published in the March 2006 edition of The New England Journal of Medicine, entitled "Who is at Greater Risk for Receiving Poor-Quality Health Care?" This study found that the majority of individuals received substandard, poor-quality care. There was no significant difference between different income levels, or between individuals who have insurance and those who do not.
1. Lenfant C, New England Journal of Medicine. "Clinical Research to Clinical Practice - Lost in Translation" 2003;349:868-874.
2. William Shankle, MD. Key Note Presentation. International Conference on the Integrative Medical approach to the Prevention of Alzheimer’s Disease. Oct 11, 2003.
3. Phillip Pizzo, MD. Stanford Medical Magazine. Stanford University School of Medicine.
4. Begley S. "Too Many Patients Never Reap the Benefits of Great Research." Wall Street Journal. September 26, 2003.
5. "Science Knows Best." Daily Policy Digest. National Center for Policy Analysis. Sept 26, 2003.
6. Niteesh. C, et al. "Systematic Review: The relationship between clinical experience and quality of health care." Annals of Internal Medicine. February 15, 2005.
7. Balas, E.A. "Information Systems Can Prevent Errors and Improve Quality. Journal of the American Medical Informatics Association. 2001; 8(4):398-9.
8. National Institute of Medicine Report, 2003b
9. California Assembly Bill Number: AB 592 Amended Bill Text; Amended in Assemby April 4, 2005, Introduced by Assembly Member Yee February 17 2005. An act to amend Section 2234.1 of the Business and Professions Code, relating to healing arts.
10. The Principals of Medical Ethics adopted by the American Medical Association in 1980.
11. Asch SM, et al. "Who is at Greater Risk for Receiving Poor-Quality Health Care?" New England Journal of Medicine. 2006;354:1147-1155.
Once again, what CFS patients have been saying for years is borne out by research performed by doctors and health care organizations, and published in reputable medical journals. This is not a case of CFS patients having a vendetta against doctors, but that the patients have been telling the truth about how few doctors know that anti-depressants have repeatedly been proven useless against CFS.
A good friend has a rheumatologist who told her that he would always listen to her input because "I have to read up on 400 diseases, you only have to read up on one." Unfortunately, open-minded doctors like that aren't easy to find. That's why so many CFS/fibro informational websites have a list of good doctors who either keep up on the literature or are open to reading the literature that the patient has kept up on.
Equally unfortunately, when I tried to get an appointment with my friend's rheumatologist, even my friend's name was not enough to get me in the door when I said I had CFS. (You can tell where along the continuum a medical group first started dealing with CFS by whether you're sent to Infectious Disease, Rheumatology, or Neurology. Although it starts with a virus, the symptoms are mostly neurological.)
The research is clear: you cannot rely on your doctor to know what's best. You will probably have to educate him. If you accept the treatment he was taught 20 years ago, when many people were erroneously classifying CFS as depression or some other psychological problem, you may end up permanently disabled like so many other CFS patients who deteriorated because they followed doctor's orders to the letter. The problem was not patient noncompliance, but doctor ignorance.