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Study Answers Question: Why Are Physicians Resistant to Accepting Fibromyalgia Patients?

  [ 9 votes ]   [ 1 Comment ] • August 12, 2014

Association of physicians' illness perception of fibromyalgia with frustration and resistance to accepting patients: a cross-sectional study.


By Mieko Homma, et al.

The aim of this study was to elucidate whether physicians' illness perceptions correlate with their frustration or resistance to accepting patients with fibromyalgia (FM).

In this cross-sectional postal survey, questionnaires were sent to member physicians of the Japan College of Rheumatology and Japan Rheumatism Foundation. Measures collected included the Brief Illness Perception Questionnaire with Causal Attribution, the Illness Invalidation Inventory, and the Difficult Doctor-Patient Relationship Questionnaire (DDPRQ-10). Multiple logistic regression was performed to examine associations between the DDPRQ-10 and resistance to accepting patients with FM for treatment.

We analyzed data from 233 physicians who had experience in consulting with patients with FM.
  • Only 44.2% answered that they wanted to accept additional patients with FM.

  • Physicians' frustration was associated with difficulty controlling symptoms, patients' emotional responses, and causal attribution of FM to patient internal factors.

  • Conversely, lower levels of frustration were associated with causal attributions to biological factors and uncontrollable external factors.

  • However, the "difficult patient" perception did not correlate with resistance to accepting patients with FM.

  • Difficulty controlling symptoms with treatment was the one factor common to both physicians' frustration and resistance to accepting patients with FM.

Physicians may hesitate to accept patients with FM not because of the stigmatic image of the "difficult patient," but instead because of the difficulty in controlling the symptoms of FM. Thus, to improve the quality of consultation, physicians must continuously receive new information about the treatments and causes of FM.

Source: Clinical Rheumatology, August 3, 2014. By Mieko Homma, Hirono Ishikawa and Takahiro Kiuchi. Department of Health Communication, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan,

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Article Comments Post a Comment

Fibromyalgia Study
Posted by: carameads
Aug 13, 2014
As a healthcare worker for many years, I was puzzled by many physicians' hesitancy towards treating Fibromyalgia patients. These patients came in with changing symptoms and frustration that there were not absolute solutions. The physicians had few tests to diagnose Fibromyalgia, only to rule out other problems. The frustration level for both doctors & patients was so high, & many doctors believed these changing symptoms indicated hypochondria &/or emotional problems. Even today I know many health providers who don't believe Fibromyalgia is a valid diagnoses. Until a definitive test and successful protocol for treatment is accepted, physicians will continue to choose not to treat these patients. How do you treat a diagnosis you don't believe really exists?
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