How to be a better Headache or Migraine Doctor

Some people love their doctors.  Others … well … feel they could be getting better treatment elsewhere.  What makes the difference?  What makes a good migraine doctor?

In our last poll, we asked our visitors about their migraine doctors and specialists.  The question was, I would be happier with my doctor/specialist more if he/she … what?

Here are the answers, starting with the one with the most votes:

"I would be happier with my doctor/specialist more if he/she …"

  • showed more concern/took me seriously.  Doctors tend to be rushed, is that the reason why they sometimes brush off patients?  I think there’s something more here though.  There are some doctors who still assume that almost every headache is minor, and they aren’t aware of the impact some of these disorders have on their patients lives.  Sometimes that’s because patients don’t explain the life impact fully.  But other times doctors make assumptions that they shouldn’t.  I think this is changing, but there’s still work to be done.  This was easily the top answer, chosen by 18.5%, or almost 1 in 5 patients.
  • was more knowledgeable about my condition.  I think more knowledge would help with the first issue as well.  Let’s be fair here though.  Our understanding of neurology and the brain has exploded in the last 20 years.  It’s not possible for every doctor to keep up, and very difficult for a specialist to keep up.  You should expect your doctor to be aware of the basics of major conditions such as migraine, but you can’t expect her to know all the latest research and treatments.  Patients need to find someone who specializes in their condition if at all possible, and doctors need to be willing to admit their limitations and make referrals.
  • thought more creatively about issues related to my treatment.  This was almost tied with the last one, with about 1 in 8 patients with these concerns.  This is a tricky one, but it does point to the fact that medicine is an art as well as a science.  There are doctors who just keep going over the same ground again and again, but could get to a better treatment with a little creative thinking, a few creative questions, a little digging.  It’s easy to start thinking you’ve seen it all before, but in the world of headache every patient really is unique.  Don’t be afraid to think outside the box.
  • was open to a wider variety of treatments.  The next two are tied, with about 1 in 9 patients answering this way.  This may have a lot to do with alternative treatments.  Doctors are becoming more and more open to alternative treatments.  One reason is that the research is starting to prove that many alternative treatments have real value.  On the other hand, some have very little evidence to back them up.  Find a doctor who will look at the evidence, and at the very least listen to what treatments you’re considering and offer suggestions or warnings.
  • explained to me what she/he’s thinking.  It’s not only condescending, it’s very frustrating when a doctor won’t work together with her patients.  It is essential in today’s world for doctors and patients to work together to find treatments that work.  If your doctor won’t take the time to explain to you why she is recommending a treatment or drug, consider looking for another doctor.
  • listened more.  More than 1 in 10 answering the poll put this in their top 3.  Let’s put it this way.  With all the frustration, misdiagnoses, and patients who go years without proper treatment, something is not being done right.  I’m convinced this is part of it.  I’m also convinced it’s a two way street.  Doctors need to learn to listen, question, and pay attention.  Patients also need to learn to come prepared, question, and explain things clearly and succinctly.  We all have to do better in this area to fight headache and migraine effectively.  Tips for talking with your doctor here and here.
  • was more up to date on current treatments/issues.  These last few were mentioned less, so I’m just going to include this one in the list and then mention the others briefly.  About 1 in 13 patients mentioned this one, and it’s certainly related to some of the other points above, so still important.  Being knowledgeable, up to date, and open to a wider variety of treatments all go together.  Migraine and headache are major issues in today’s society, and doctors need to stay abreast of the issues or send their patients to someone who is.

There were three more that were still important concerns but only mentioned by a few patients.  Some said that they wished their doctors trusted them more, which I think goes along with working together.  Quite a few also said they wished their doctor wouldn’t give up so easily.  Though only a few mentioned it in this poll, this is not the first time I’ve heard this, and it is an important issue.  In this day and age, no one is going to live long enough to try every available migraine treatment, for example.  No doctor should throw up her hands and say,"Well, we’ve tried it all!"

Some people said none of the above of course, so I’ll leave that up to your imagination (or your comments!).  Finally, a few simply wished their doctor was more competent.  Thankfully, that was a very small minority.

Most doctors do seem to be working hard, working with their patients and trying to help.  I have a lot of respect for the many doctors and specialists who have helped so many.

Still, I know that doctors can do better.  I hope those of you reading this will simply take it as data to use to make your practice even better, because I know that the vast majority of you want to help your patients find the answers.

Let’s work together.  It’s time to fight back.

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2 comments… add one
  • DJ Jun 30, 2009

    Great article. I’d like to add the most important quality of a GP/doctor is actual willingness to treat migraine!!!! Many GP’s in Australian simply won’t treat migraine because they believe they are due to anxiety which they also won’t treat.

  • Michael Leis Oct 11, 2009

    After going through four different doctors, the best care I’ve gotten is with a neurologist and my general doctor as a backup / prescriber when I can’t get into see (or am waiting for my) neurologist.

    Many general practitioners want to just treat the pain, and migraine specialists are too academic and too experimental. At the beginning of each cycle, my neurologist does a thorough brain health exam, apprises me of anything new/worthwhile he’s read or seen with his patients, and then set a course of treatment. This has lead to my best treatment mix of oxygen/verapamil/imitrex — and anecdotal info that I’ve tried.

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