Did I say that botox is on par with herbal therapy? I will put botox, herbal therapy, aroma therapy, massage therapy, and a whole bunch of other stuff into one big category;
STUFF THAT MOST HEALTH INSURANCE COMPANIES DO NOT PAY FOR.
I am not here to argue which is most effective and blah blah blah, but only to point out that there is a lot of stuff out there that is expensive and yet the headache sufferer will not have the opportunity to utilize these therapies.
I think it is incorrect to assume that most neurologist feel that headache is a primary psychiatric disorder. I am sure that there are plenty of non-neurologist who feel this way (know some unfortunately). Certainly some psychiatric overlay in some cases, but certainly not a psychiatric disorder alone.
Lets all get up on our high horses and talk about how patients so greatly benefit from inpatient therapy. But who pays for this? Did you know that at the Diamond Clinic in Chicago they have people around the clock who spend their entire work day on the phone with health insurance companies trying to get things like inpatient admissions approved? Do you have that kind of staff? Do you spend that much time on the phone yourself as a physician? Unfortunately, most are offered inpatient admission only to discover that they cannot afford it. Others actually become irrate when they do have say an inpatient admission for DHE and then get stuck with a bill. They blame it on the doc.
You make an excellent point that I do not think anybody would disagree with. There are treatments that help these people, there are things that need to be done. But as I have pointed out by using the diamond clinic as an example, this is why the specialist are needed. So that they can devote the time, effort, energy to help these patients. In addition pursue research.
So to answer your original question, no saper is not wasting his time.