Michael Murphy1, Nicholas Kontos2, Oliver Freudenreich2. 1. Department of Psychiatry, Massachusetts General Hospital, Boston, MA; McLean Hospital, Belmont, MA. Electronic address: mmurphy56@partners.org. 2. Department of Psychiatry, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA.
Abstract
BACKGROUND: Patients with functional somatic syndromes are often difficult to treat. The relationship between doctors and patients can be strained, which limits communication. Instead, patients often communicate with each other over the Internet in electronic support groups. OBJECTIVE: This perspective summarizes studies of patient-to-patient communication over the Internet and uses the concept of contested illness to provide insights into the experiences of patients with functional somatic disorders. DISCUSSION: Conflict between a patient and their physician is a key feature of functional somatic syndromes. Physicians and patients do not have a shared understanding or appreciation of the patient's experiences. Patients with functional somatic syndromes often value their own embodied experience over medical knowledge. At the same time, they remain deeply invested in finding a "good doctor" who believes that the patient is suffering, agrees with their conception of the cause, and assents to the treatment as directed by the patient. Electronic support groups reinforce these beliefs. CONCLUSION: Patients may benefit from a compromising, collaborative approach that is realistic about the limitations of medical knowledge. However, physicians should not engage in unsafe treatment practices. Electronic support groups exist for a wide range of illnesses and the issues that rise to the surface in functional somatic syndromes likely occur to some extent with almost every patient.
BACKGROUND:Patients with functional somatic syndromes are often difficult to treat. The relationship between doctors and patients can be strained, which limits communication. Instead, patients often communicate with each other over the Internet in electronic support groups. OBJECTIVE: This perspective summarizes studies of patient-to-patient communication over the Internet and uses the concept of contested illness to provide insights into the experiences of patients with functional somatic disorders. DISCUSSION: Conflict between a patient and their physician is a key feature of functional somatic syndromes. Physicians and patients do not have a shared understanding or appreciation of the patient's experiences. Patients with functional somatic syndromes often value their own embodied experience over medical knowledge. At the same time, they remain deeply invested in finding a "good doctor" who believes that the patient is suffering, agrees with their conception of the cause, and assents to the treatment as directed by the patient. Electronic support groups reinforce these beliefs. CONCLUSION:Patients may benefit from a compromising, collaborative approach that is realistic about the limitations of medical knowledge. However, physicians should not engage in unsafe treatment practices. Electronic support groups exist for a wide range of illnesses and the issues that rise to the surface in functional somatic syndromes likely occur to some extent with almost every patient.
Authors: Paul G Auwaerter; Johan S Bakken; Raymond J Dattwyler; J Stephen Dumler; John J Halperin; Edward McSweegan; Robert B Nadelman; Susan O'Connell; Sunil K Sood; Arthur Weinstein; Gary P Wormser Journal: J Med Ethics Date: 2010-11-21 Impact factor: 2.903
Authors: Paul G Auwaerter; Johan S Bakken; Raymond J Dattwyler; J Stephen Dumler; John J Halperin; Edward McSweegan; Robert B Nadelman; Susan O'Connell; Eugene D Shapiro; Sunil K Sood; Allen C Steere; Arthur Weinstein; Gary P Wormser Journal: Lancet Infect Dis Date: 2011-09 Impact factor: 25.071