Your absolutely right about patients wanting doctors to validate their complaints. But if you don't think about it everyday, your probably not one of those, and are just tired, a good vacation might do you some good.
I think validationg is what you are supposed to do as a physician, you listen, reassure the pt, validate their concerns, and lead them down the road to good health. However, FM and CFS popped up when doctors were either to afraid to confront a patient about psychosomatic illnesses or found a patient that they could fit into the right box and that is unwilling to be healthy. Thus we end up with a diagnosis for which we cannot prove or disprove, the worst thing is you can get disabilty for it!
While some of you may think I'm a monster for saying this, I think in some ways Darwinian Theory applies here. If these patients weren't offered pain managment and consecutive (costly) therapies to treat these fictitious illnesses, the patients would effentually take care of themselves. While I think every patient should be cared for, there is a limit. Doctors need to learn how to say no, and tell these patients to get over it. Show them appropriate diet and physical activities and let them decide whether they want to get well. There has to be some amount of patient accountability.
Unfortunately we live in the era of Wal-Mart wastelines and pill popping patients that, 1) don't want to stop detrimental habits as long as there is a pill to mask the sxs it causes, 2) smoke more than ever, 3) are more sedintary than ever, 4) eat larger than ever, and 5) want immediate satisfaction. Until we improve our healthcare system to manage the chronically ill, CFS/FM and it's comorbidities (i.e, obeseity, substance abuse, etc, etc) will continue to drain our system and pockets.
Sorry I'll stop ranting, just another day at work, man I about turned this into and anti-fat people post, that would use up to much bandwidth.
