CFS is not a discrete illness, but rather a set of criteria established by a committee that encompasses a group of illnesses. As a side issue, many people have been dissatisfied by the term CFS because it does not adequately reflect the seriousness of the illness.
Given that the real illness is not specified by the term CFS, and that the illness has a major impact upon functioning, an in-depth evaluation should be conducted with each patient to determine the cause. This requires multiple laboratory tests. Once the real cause has been identified, in most cases it can be treated, and in many cases it can be cured.
About ten to fifteen years ago in the United States, there was a shift from a physician shortage to a physician surplus. Doctors are being forced to accept a much lower income, and those in private practice usually have to market themselves. Yet there is a desperate shortage of physicians competent in the field of functional medicine, and those that do enter this field are often looked down upon by their colleagues. It should not be difficult for physicians to make a specialty shift by creating their own program via individual tutelage, tapes, seminars, and the internet. Given the hard science core of functional medicine today, it should not be difficult for this specialty to gain recognition. Physicians undertaking this should be affiliated with large teaching hospitals and talk at medical education seminars.
Patients can play a role in this also. Most doctors feel trapped by managed care and are looking for solutions. The answer is to find a need and fill it. Convince your doctor he would be better off diverting much of his energy from marketing into need-filling.
A good deal of energy is being spent by CFS organizations toward changing the name of the illness. Believe me I understand the issue. But I propose that it be approached differently. We must keep in mind that the primary goal is to get well, and get back to “having a life.” If we keep this as our primary goal, the name issue will take care of itself. I have a personal stack of records several inches thick and nowhere does it mention the term: “chronic fatigue syndrome.” If you are a patient, you have the power right now to change the name for you, and get closer to a better understanding of your body and how it malfunctions at the same time. If you have chronic fatigue, you probably have at least five legitimate universally acceptable medical diagnoses that should all be listed in your records (other than CFS.)
If you have studied your illness, and your studies have brought you to a better understanding of yourself that might help someone else, I would be happy to post your story to this web site.
It now requires a physician’s prescription to obtain a laboratory test. I believe this is wrong because in this age of managed care, many doctors will not order tests because of the cost to the company. People have the right to know what is going on in their bodies. While it is true that a patient may not understand or misinterpret the test results, this would be an implied risk that the patient would or should understand.