Recession Hits Home for Physicians
Thursday May 28, 2009
Health care has always been considered a "recession proof" profession, but that may not be the case this time around. A recent survey released by the American Academy of Family Physicians shows that patients are visiting their physicians less and less, even postponing important health screenings like Pap smears and colonoscopies. Appointment cancellations are up, as are the number of uninsured patients visiting the office. All of these trends are quite concerning to family physicians in particular since they are often the ones managing chronic conditions and ensuring patients receive appropriate screening tests.
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One of the most concerning stats to come out of this survey is that people are stressed out more than ever. Nearly 90% of physicians surveyed said that patients are expressing a concern over how they will pay their bills. And, 87% physicians said they are seeing an increase in patients with signs and symptoms of severe stress. As headache sufferers, you will recognize that stress can be a common trigger for headaches. It can also increase one's risk of a variety of health problems like heart disease. If you are concerned about the rising costs of health care, discuss these concerns with your health care provider and see what he or she can do to help you.
To keep up on useful information
related to headaches and migraines,
subscribe to the
Headaches and Migraines Newsletter.
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Comments
It’s so sad that you still think stress is such a huge trigger AND that you still call migraines “headaches.”
When a headache happens during a migraine, it’s a SYMPTOM, doctor. A migraine attack doesn’t always have a headache as a symptom, doctor.
I’d bet you that if you challenged your patients who think stress is a migraine trigger to keep a very detailed diary, you’d find that it’s not stress that’s the trigger; it’s things they do or don’t do that are the triggers. Missing meals, dehydration, messed up sleep, crying, and so on. THOSE are the triggers; not the stress.
Please, please, please. You are in a position to do a lot of good for a lot of people, but you need to get a clue!
Thank you, Arabella, for commenting here on the blog. I always appreciate feedback and interest on our site here. You are correct that there are migraine sufferers that present with symptoms other than a classic headache. There are abdominal and ocular migraines, for example, that may not be painful at all. I do try to distinguish between migraines and headaches, recognizing that the two do not always go together.
In fairness, though, a vast majority of migraineurs would say that headache is a major symptom they experience during a migraine attack. I’m glad you mentioned a migraine diary because I think that is an excellent way for people to gain a real understanding of their condition.
In the blog entry I did say that stress could be a “headache trigger,” and this is something we see time and time again. Thank you, also for listing common migraine triggers.
Wow. You knowledge base is far, far behind current research and knowledge. May I recommend a document to you? The International Classification of Headache Disorders, Second Edition. The International Headache Society. 2004. Within the IHS guidelines, there is no diagnosis of “ocular migraine.” However, the research I’ve done indicates that any form of migraine can occur without the headache phase — migraine with or without aura, basilar-type migraine, any of them — and at that point are described as “acephalgic” or “silent” migraine with aura or whatever form of migraine the migraineur is experiencing.
I’m sad to see that yo entirely missed my point about stress. Even the IHS has removed stress from their list of triggers and added to a list of “exacerbating factors” that make a migraineur more susceptible to their triggers. Again, I would challenge people who think stress is a trigger to keep a very detailed diary during stressful times. I’d bet the come up with other things that are triggers rather than the stress.
My intent was not to get into a debate with you, but rather underscore important points to consider when dealing with headaches. In tension type headaches, stress is most certainly a valid trigger. In migraines, you are correct, that stress is not so much the trigger as much as other factors. Again, I agree the diary is a good place to tease out these details.
Ocular migraines are a common variant where a migraine is accompanied by visual disturbances or loss. In many occasions, there may not be any actual pain associated with the symptoms.
Dr. Farley,
My intention wasn’t to get into a debate with you either, but it has been interesting. I thought that, surely, a company with the reputation of About’s had “guides” who were:
a) current in their knowledge base,
b) open to continuing to learn,
c) capable of recognizing and admitting when they were wrong.
Since you evidently won’t go to the IHS guidelines, I’ll bring part of them to you. Again, “ocular migraine” is a diagnosis not recognized in the IHS classifications. It is a term that is used by some people. Indeed, if you do a search, you will find references to it all over the Internet. References with many different definitions. Thus, the reason for the IHS document. Since it seems you don’t want to look it up, HERE are the forms of migraine acknowledged by the IHS:
1.1 Migraine without aura
1.2 Migraine with aura
1.2.1 Typical aura with migraine headache
1.2.2 Typical aura with non-migraine headache
1.2.3 Typical aura without headache
1.2.4 Familial hemiplegic migraine (FHM)
1.2.5 Sporadic hemiplegic migraine
1.2.6 Basilar-type migraine
1.3 Childhood periodic syndromes that are commonly precursors of migraine
1.3.1 Cyclical vomiting
1.3.2 Abdominal migraine
1.3.3 Benign paroxysmal vertigo of childhood
1.4 Retinal migraine
1.5 Complications of migraine
1.5.1 Chronic migraine
1.5.2 Status migrainosus
1.5.3 Persistent aura without infarction
1.5.4 Migrainous infarction
1.5.5 Migraine-triggered seizure
1.6 Probable migraine
1.6.1 Probable migraine without aura
1.6.2 Probable migraine with aura
1.6.5 Probable chronic migraine
If you look at the various online references to ocular migraine, many seem to describe acephalgic migraine with aura, some seem to describe retinal migraine.
No need to be concerned. I’m through with this discussion and won’t bother you again. It’s sad to see a site that used to be so dependable now in the hands of someone who seems content to perpetuate misinformation and misconceptions rather than dig deep enough to provide readers with information that could actually be helpful.
Sad indeed.
Wow. Thank you, Arabella for the information. I always thought I was getting good information here, but it’s pretty clear that you know what you’re talking about, and have the data from reputable sources to back it up.
It makes sense- when I’m stressed, I tend to not sleep well, or eat correctly. I often wind up eating trigger foods ’cause I’m not thinking about it.
I find it weird that this person who commented on this blog has more knowledge about headaches than the person providing the medical information. Is this doctor a headache specialist?
Dr. Foley;
This is just pathetic. The information Arabella gave you was quite correct. There is no formal diagnosis of “ocular Migraine.” The term is used, or I should say “MISused,” all too frequently. When the actual diagnosis is determined, those “ocular Migraines” may be Migraine with Aura, Basilar-Type Migraine, Hemiplegic Migraine, or Retinal Migraine.
Doesn’t being an About.com guide mean that you’re supposed to give accurate and dependable information? Were you really dedicated to doing that, you’d welcome information that helps you learn and be able to offer your readers and your patients better information and treatment. Instead, you dismissed the information offered to you, and not very gracefully.
It’s really pathetic how far this site has declined. I hope you’ll consider that nobody knows everything, and we can all stand to learn.
Perhaps you should consider joining the American Headache Society and attending some of their educational conferences. Attendance also earns you continuing medical education hours.
Please consider that you could be doing this job far better.
Namaste,
Abi