Chronic pain is a leading cause of disability globally and associated with enormous health-care costs.
The discrepancy between the extent of tissue damage and the magnitude of pain, disability, and associated symptoms represents a diagnostic challenge for rheumatology specialists.
The problem with the bolded bit in the above sentence is that doctors look at medical records and they assume the records are completely right and so they know the patient's medical history and they think that their investigations will determine the extent of tissue damage. But medical records are often manipulated, they contain lies, and they contain doctors' own incorrect assumptions, obfuscations and mistakes. Also I've never heard of MRIs, CT scans, X-Rays or Ultrasound scans that can show up tiny nerves that could be triggering pain. And how often are investigations done using those scans that show up blood supply? I know that blood supply can be investigated using contrast materials in some kinds of scans but such contrast isn't used every single time that such investigations are carried out.
So, with often poor and misleading scan results, blood tests, and inaccurate medical records doctors
think they know everything about the patient, but in reality, patients, with symptoms that can't be accurately diagnosed because of lack of accurate information are, in effect, put on trial (but the patient doesn't know it) on the basis of faulty information. Because the patient doesn't know the charges, and isn't aware they are on trial anyway, they aren't aware what they have to defend themselves against, they don't know the evidence against them, and they don't know what sentence has been passed by the judge (oops, I mean the doctor) who has found them guilty of something that will inevitably mean the patient is denied medical help.
The quote I bolded above specifically mentions rheumatology. But other specialists go through exactly the same process of condemnation, judgement and punishment every day with every patient. Some very rare patients come out of this judgement squeaky clean, but many of us don't because all those past judgements and sentences are never mentioned to us, but are continually used against us.
If I was to say to a doctor, what do you think you know about my medical history in year X, which is relevant to my current symptoms, they would (at best) consult a summary which told them what happened in that year and what the major findings were? But having bought a copy of my own records, I discovered that the summary of what happened in year X (five words) tells doctors about 2% (at best) of what really happened because the summarisation is nonsense. On the basis of that summary of what happened in year X I have been judged and dismissed many, many times. The labels attached to my records tell doctors a load of malicious rubbish about me, but they think they know what happened and they think they are justified in dismissing every word out of my mouth.
The other point about labelling patients is that the incorrect beliefs of a doctor in one speciality will be read by other doctors in another speciality, and so the poor treatment given to the patients spreads from one discipline to another and there is no escape.
