There are many excellent Migraine and headache specialists in practice today, but with 12% of the population suffering from Migraine disease, it can be hard to find competent Migraine care. Just this week a friend told me about a neurologist who provided no treatment or suggestions for her two-week-long Migraine, but told her she should see a psychologist. Imagine that doctor's comments being what would control your Migraine care in the future!

"My doctor put negative comments about me and my Migraines into my medical record; what if he bad-mouths me to other doctors?" I see this or similar questions frequently on this site. Patients worry that their current doctor could make it hard for them to get the medical care they need. I don't know how often this happens in real life. As Teri Robert likes to say, "Optimal health care can be achieved only when patients are educated about their health and patients and physicians work together as treatment partners in an atmosphere of mutual respect." Your first and best strategy is always to have open and honest communication with your doctor. Let him or her know what your concerns are.

In "Fundamental Elements of the Patient-Physician Relationship," the American Medical Association (AMA) Code of Ethics states:

The patient has the right to confidentiality. The physician should not reveal confidential communications or information without the consent of the patient, unless provided for by law or by the need to protect the welfare of the individual or the public interest.¹

I believe most doctors are truly interested in caring for patients, and they take their code of ethics seriously. Doctors are not likely to be talking behind your back about you and your care. Even if a particular doctor isn't as caring as I'm assuming, practicing medicine is very difficult these days in light of rising medical malpractice insurance rates and claims against doctors. Most doctors aren't likely to risk their professional standing by chatting about you and your Migraines.

Remember that there could be statements that sound negative to you, that don't show a deep level of understanding of your medical problems or concerns, or are just plain ignorant about Migraines, but which won't really be harmful. Just for example: A statement that your Migraines are psychosomatic will be dismissed by any knowledgeable Migraine specialist. A statement that you abused medications will be real cause for concern to any doctor. So check carefully whether your disagreement is over tone or understanding, or over something of more substance.

What if you have a real reason for concern - you got a look at something negative a doctor put in your chart, or you had a conversation with your doctor where he or she said something negative about you? What can you do? Under the Health Insurance Portability and Accountability Act (HIPAA) you have a right to correct errors or place rebuttals of statements in your medical records. You might want to look at your medical records from time to time. You won't know if there's something you disagree with unless you look. It's best to be polite and non-confrontational about it. Let your doctor know what you disagree with; he or she may correct the file. If not, you can write a rebuttal and have it placed in the file. Read more about the rules in Teri Robert's article: Your Rights to Your Medical Records; and in my earlier sharepost: HIPAA and the Privacy of your Medical Information. You can also get more information and FAQs on HIPAA directly from the US Department of Health and Human Services at Health Information Privacy.