LYMEPOLICYWONK: MUS is DUMB—Doctors with Unexplained Medical Beliefs
You’ve all heard that the latest drum-roll from the rheumatologists at the IDSA hearing was essentially to say that Lyme patients have persistent symptoms and they started off with infection, but now we don’t “believe” in persistence—so what do you call it? How about “medically unexplained symptoms” or MUS for short? All of this seems to regard the real problem with Lyme disease as being what you call it. But patients know the real problem with Lyme disease is how you treat it, how you cure it, how you restore patients to their lives. Disease definitions like MUS are for drug-makers who sell drugs to a market, physicians trying to claim professional turf, and insurers trying to deny treatment reimbursement. They are not for patients. Abraham Lincoln had it right when he said: “How many legs does a dog have if you call the tail a leg? (Answer) Four. Calling a tail a leg doesn't make it a leg.” I’m not the only one who finds these acronyms aggravating and unhelpful. A post from the internet nails it:
If someone knows the author let me know so that I can give proper credit:
“Physicians fixated upon the metaphysical belief system of “If we don’t know about it, then it doesn’t exist” are suffering from a mental defect or psychological condition known as “Doctors with Unexplained Medical Beliefs”: D.U.M.B. DUMB doctors are comprised of subgroups characterized by opportunists who are feigning to be DUMB for monetary gain:
“Medicalingering” or of those doctors who are not in possession of sufficient information to render an intelligent diagnosis: “Factlessitious Disorder”. Physicians who are suffering from DUMB disorder place an inordinate emphasis on theories of psychological causality for virtually any unfamiliar complaints that are presented, and manifest a distinctive lack of observational skills when confronted with obvious abnormalities. Doctors who exhibit obsessive preoccupation with psychosocial etiologies should be regarded with extreme caution: “Psychosomatization Fixation Disorder” or “Psychologizing” is a distinctive characteristic of mental illness, and should be considered a warning sign that the individual is not rational and may in fact be dangerously DUMB.
DUMB disorder may be concomitant but should not be confused with Signs of Thoroughly Unmistakable Physician Intelligence Deficiency: “S.T.U.P.I.D.”, as a STUPID physician is uniformly incompetent, while a DUMB doctor is only mentally paralyzed into “psychologizing” by unfamiliar symptoms and complaints.”
Hi Lorraine,
It seems like the acronym quote comes from Erik Johnson, an Incline Village Nevada Chronic Fatigue Syndrome survivor posted as a response to a post at Hillary Johnson's blog at <a href="http://www.oslersweb.com/blog.htm?post=638469">oslersweb.com</a>.
No relation, right?
Rick
Hi,
I would go a step or two farther in elucidating the reason for physicians acting this way. Its too easy to blame greed, I think the true reasons run much deeper.
1) Pride. Simply put, many physician's don't want to admit they have been stumped or don't have a good answer because their egos can't handle that answer.
2) Physicians want to, almost need to, believe in the "system" of medical recommendations by experts. There is simply too much information available today for a physician to be an expert in everything they are reading, diagnosing, and treating. As a result they turn to those who they view as being an expert so they can have greater confidence in the care they are delivering to the patient. This system requires a belief in the superiority of knowledge and correctness of the expert. Anything that makes physicians question the expert undermines their ability to function in that system because they can no longer trust it. This isn't so much a problem with a single isolated fact or disease, but is a huge issue in undermining physician confidence in guidelines as a whole. When they can't believe in the system, its a very insecure place to be for a physician; so most avoid that place at all costs.
Regards,
Matt Steenberg