Abstract
Objectives: Fibromyalgia syndrome [FMS] is a common condition, often diagnosed in the primary care setting, causing diffuse pain with additional somatic symptoms. Many physicians have questioned the existence of FMS due to an unclear pathophysiological origin and its overlap with other somatic syndromes. We sought to assess the perceptions of FMS among United States medical students and internal medicine and family medicine trained physicians working in an academic hospital.
Methods: Residents and attendings working in a local teaching hospital were given questionnaires during undergraduate medical education sessions and academic conferences in internal medicine and family medicine. Medical students received surveys during small group sessions and through student mailboxes.
Results: Seventy-two internal and family medicine trained physicians and 211 medical students were surveyed. In assessing whether FMS was primarily physiological or psychological in origin, 66% of physicians compared to only 29% of medical students [p < 0.001] chose a psychological etiology. Among physicians, women [82%] and American medical graduates [77%] were more likely to endorse a psychological mechanism than their counterparts [53% p < 0.010, 50% p = 0.022, respectively]. Additionally, when physicians were asked whether they believed FMS was an “actual illness,” 19% responded “no.”
Conclusions: Fibromyalgia syndrome continues to be a controversial illness in the United States, especially when compared with values attained from international studies. Although current academic physicians appear to be skeptical of FMS’s existence or its potential physiological mechanisms, medical students are more likely to support a physiological mechanism.