Communication Barrier in Migraine Treatment

We are excited to kick off a series of articles today by Alexander Mauskop MD, FAAN, a professor of neurology and leading figure in headache writing and research. Dr. Mauskop is the author of Migraine and Headache (Oxford American Pain Library).

Dr. Mauskop has given lectures at the medical schools of Cornell, Harvard, and Columbia, as well as the Mayo Clinic, and we are delighted to have him share his wisdom here on Pill Advised.

Communication Barrier in Migraine Treatment

by Dr. Alexander Mauskop

Treatment of migraines leaves a lot to be desired and in part not because we do not have effective treatment, but because of a communication barrier.

Doctors appear not to want to hear what migraine patients have to say about their headaches, according to a remarkable study by a top headache researcher Richard Lipton and his colleagues.

Patients and doctors agreed to be videotaped during a visit and 60 such interactions were analyzed. The analysis showed that doctors did not ask about the disability of headaches and tended to ask closed-end short questions.

More on Migraines: Food Allergies Cause Migraine Headaches

Very often the information they did obtain was incorrect. 55% of doctor-patient pairs were misaligned regarding frequency of attacks; 51% on the degree of impairment.

Of the 20 (33%) patients who were preventive medication candidates, 80% did not receive it and 50% of their visits lacked discussion of prevention.

The authors recommended that doctors assess impairment using open-ended questions in combination with what is called the ask-tell-ask technique.

Read: Behavioral Headache Treatment Cheaper Than Prescriptions?

Alexander Mauskop MD, FAAN, Associate Professor of Neurology at SUNY – Downstate Medical Center, is the Director and founder of the New York Headache Center. Dr. Mauskop is board-certified in Neurology with subspecialty certification in Headache Medicine. He has delivered over 400 scientific presentations and lectures and is a reviewer for the New England Journal of Medicine, Neurology, Headache, and several other medical journals. For the past 21 years, has been the Director of an annual educational symposium for physicians. Over 200 doctors from around the world have visited the New York Headache Center to learn advanced treatment techniques.

Dr. Mauskop is the author of Migraine and Headache (Oxford American Pain Library) and What Your Doctor May Not Tell You About Migraines: The Breakthrough Program That Can Help End Your Pain.

He has repeatedly been chosen as one of New York magazine’s Best Doctors in New York, as one of New York Times Magazine’s, “Super Doctors” and as Castle and Connolly’s “Best Doctors”. Dr. Mauskop has appeared on television shows including Tom Brokaw’s News Hour, Extra, and PBS specials, and he has been featured in Vogue, O Magazine, and many other publications. He has given lectures at the medical schools of Cornell, Harvard, Columbia, NYU and Dartmouth, and at the Mayo Clinic and Cleveland Clinic.