Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
ReplyLetters

Response

Stephen J. Genuis
Canadian Family Physician September 2014, 60 (9) 797-798;
Stephen J. Genuis
Edmonton, Alta
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • eLetters
  • Info & Metrics
  • PDF
Loading

Thanks to Dr Muldoon for her thought-provoking letter. There are certainly individuals who present to physicians with seemingly trivial complaints and some who do not follow basic health measures, yet express surprise when they become ill. People are not baffled when poorly maintained or aging automobiles malfunction, yet some people pay little heed to basic self- maintenance and are somehow astonished when they feel unwell. Furthermore, there are individuals who sustain utopian ideals of how they should consistently feel and harbour unrealistic expectations of health providers, expecting to be “fixed” despite less-than-ideal health practices. However, this is not the general presentation of most patients with multimorbidity with sensitivities (MWS) as discussed in the article “Pandemic of idiopathic multimorbidity.”1 Furthermore, with specific laboratory and environmental testing, objective and measurable abnormalities are usually identified when assessing patients with MWS.

However, it is my experience that many physicians are unfamiliar with sensitivity-related illness and might thus be unable to account for the symptoms and concerns of patients with MWS. I routinely hear the frustration of individuals who comment that their doctors are unable to explain multisystem health complaints and therefore think that such patients are “whiny” or perhaps mentally ill. I think it is important for us, as physicians, to be cautious that our dismissal of patients’ symptoms does not represent a visceral response to our own inability to elucidate the source of their concerns.

Dr Muldoon’s letter provides an opportunity to raise a noteworthy point with regard to physician perspectives. The 2003 Canadian Medical Association survey of members2 and other publications in Canada3 and abroad4,5 provide insight into the attitudes, beliefs, and morale of some physicians in this country and elsewhere. The findings reveal that many physicians feel discouraged, clinically ineffective, and unproductive in their work. As a result, some doctors find the practice of medicine to be intellectually unrewarding. In fact, a number of e-mails I received in response to my article talked about frustration, futility, and ineffectuality in managing patients with MWS. I have often wondered whether many empathetic practitioners, particularly primary caregivers, find it difficult to repeatedly listen to the sad and sometimes desperate accounts of innumerable chronically ill persons day after day, and perhaps find it hard to maintain motivation when encumbered by a palpable inability to alleviate suffering in many cases. This is particularly relevant as about 72% of the global burden of disease in adults now represents chronic illness,6,7 often involving multiple ongoing conditions. The frustration all around is encapsulated by the name of a recent paper entitled “‘Where do we go from here?’ Health system frustrations expressed by patients with multimorbidity, their caregivers and family physicians,”8 one of the many dozens of medical publications on this matter released in the past few months. Furthermore, this issue is clearly of enormous relevance and concern to the medical community, as a previous article on the subject of multimorbidity9 is one of the most cited papers ever published in Canadian Family Physician.10

In the 2 articles on multimorbidity in the June issue of Canadian Family Physician,1,11 I presented information about sensitivity-related illness—an emerging immune disorder resulting from toxicant exposures—and its relationship to MWS and chronic illness. With the recognition that numerous chronic afflictions can be ameliorated and that health can often be restored with the guidance and care of informed physicians, expectations of good health are very realistic. With the knowledge and tools to investigate and successfully assist many patients to overcome their chronic conditions, the practice of medicine can be effective, intellectually challenging, and immensely rewarding.

Footnotes

  • Competing interests

    None declared

  • Copyright© the College of Family Physicians of Canada

Reference

  1. 1.↵
    1. Genuis SJ
    . Pandemic of idiopathic multimorbidity. Can Fam Physician 2014;60:511-4. (Eng), e290–3 (Fr).
    OpenUrlFREE Full Text
  2. 2.↵
    1. Canadian Medical Association
    . Who cares for the caregiver? CMA Interface 2003;4:2.
    OpenUrl
  3. 3.↵
    1. Leiter MP,
    2. Frank E,
    3. Matheson TJ
    . Demands, values, and burnout: relevance for physicians. Can Fam Physician 2009;55:1224-5, e1-6. Available from: www.cfp.ca/content/55/12/1224.full.pdf+html. Accessed 2014 Aug 7.
    OpenUrlAbstract/FREE Full Text
  4. 4.↵
    1. Smith R
    . Why are doctors so unhappy? There are probably many causes, some of them deep. BMJ 2001;322(7294):1073-4.
    OpenUrlFREE Full Text
  5. 5.↵
    1. Regehr C,
    2. Glancy D,
    3. Pitts A,
    4. LeBlanc VR
    . Interventions to reduce the consequences of stress in physicians: a review and meta-analysis. J Nerv Ment Dis 2014;202(5):353-9.
    OpenUrlCrossRefPubMed
  6. 6.↵
    World Health Organization. Preventing chronic diseases. A vital investment. Geneva, Switz: World Health Organization; 2005. p. 1-202. WHO global report.
  7. 7.↵
    1. Horton R
    . The neglected epidemic of chronic disease. Lancet 2005;366(9496):1514.doi:10.1016/S0140-6736(05)67454-5
    OpenUrlCrossRefPubMed
  8. 8.↵
    1. Gill A,
    2. Kuluski K,
    3. Jaakkimainen L,
    4. Naganathan G,
    5. Upshur R,
    6. Wodchis WP
    . “Where do we go from here?” Health system frustrations expressed by patients with multimorbidity, their caregivers and family physicians. Healthc Policy 2014;9(4):73-89.
    OpenUrlPubMed
  9. 9.↵
    1. Fortin M,
    2. Lapointe L,
    3. Hudon C,
    4. Vanasse A
    . Multimorbidity is common to family practice. Is it commonly researched? Can Fam Physician. Vol. 51. 2005. p. 244-5. Available from: www.cfp.ca/content/51/2/244.full.pdf. Accessed 2014 Aug 14.
    OpenUrlAbstract/FREE Full Text
  10. 10.↵
    Canadian Family Physician [website]. Most-cited articles as of August 1, 2014. Mississauga, ON: College of Family Physicians of Canada; 2014. Available from: www.cfp.ca/reports/most-cited. Accessed 2014 Aug 8.
  11. 11.↵
    1. Genuis SJ,
    2. Tymchak MG
    . Approach to patients with unexplained multimorbidity with sensitivities. Can Fam Physician 2014;60:533-8.
    OpenUrlAbstract/FREE Full Text
PreviousNext
Back to top

In this issue

Canadian Family Physician: 60 (9)
Canadian Family Physician
Vol. 60, Issue 9
1 Sep 2014
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Response
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Response
Stephen J. Genuis
Canadian Family Physician Sep 2014, 60 (9) 797-798;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Response
Stephen J. Genuis
Canadian Family Physician Sep 2014, 60 (9) 797-798;
Reddit logo Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Footnotes
    • Reference
  • Info & Metrics
  • eLetters
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • No citing articles found.
  • Google Scholar

More in this TOC Section

  • We are humans first
  • Truth about grief
  • Today’s residents are ready to lead
Show more Letters

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • RSS Feeds

Copyright © 2023 by The College of Family Physicians of Canada

Powered by HighWire