"You should really consider someone else!"
After I overcame an infantile urge to throttle this patient, or at least hit her over the head with my goniometer, I gave the matter some mature reflection. I have long maintained that fibromyalgia patients are the most unhappy, time-consuming, and frustrating part of my practice. It’s much easier to deal with a patient with rheumatoid arthritis and 30 swollen joints than it is to deal with the battle cry of "I hurt all over." Perhaps, at some later date, I will give fibromyalgia my full attention and explain why these patients frequently make me hurt all over.
Perhaps this deeply disgruntled patient had some valuable lessons for me. After many years of practice, the difference between rheumatoid arthritis and fibromyalgia has become so glaringly obvious, but perhaps I didn’t take the time to explain this to the patient carefully enough. It can be easy for a physician to casually ignore a weakly positive rheumatoid factor as just another "false positive," but patients frequently get hung up on these tests and think that tests are the mainstay of diagnosis. I’m sure I explained all this, but maybe I didn’t communicate it well enough.
Obviously, displaying a few comments from some very sour patients creates a deeply flawed rating system. I thought about helping to correct the situation by asking a few of my more adoring patients to rate my practice, but why take chances, I think I will ask my Mom to review my stellar medical skills.
Dr. Greenbaum is a rheumatologist who practices in Greenwood, Ind.