CBT is becoming treatment of choice ( further trial this week from Holland,
predictable results in that CBT beats groups support or usual treatment and
severity / duration of symptoms and bodily preoccupation re cause of illness
If he's prepared to buy a middle ground view of his symptoms (ie not rampant
ME association member) then ref to a psychologist skilled in CBT may be
worthwhile. Our HB won't fund referrals out of area to CFS services because
local trust provide CBT in house ( fair enough IMO)
Chalk another one up to the Glasgow neurologists campaign to create
perpetual diability. And go no further with the insurance company than that.
----- Original Message -----
From: "Ian McNicoll" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Monday, March 19, 2001 11:50 PM
Subject: Private sickness insurance and Chronic fatigue
> For discussion.
> Young man with long (years) history of chronic fatigue/anxiety
> /depression. Has been round the usual loop of consultants with an
> interest ( which rapidly faded when Coxsackie was removed from the
> picture), psychiatric intervention, alternative medicine etc etc. Held
> by DSS to be on chronic sick. Not seen in the practice for over 2 years.
> I received a detailed report from an occupational physician who had
> interviewed/examined my patient on behalf of his insurance company and
> suggested that I referred him to a specialist CF rehabilitation service.
> Such a thing does not exist in our locale. I wrote back as such. I now
> receive another letter suggesting that he be referred to a psychiatrist.
> I will of course be discussing this with the patient himself but I feel
> very unhappy that I am being asked to make referrals that I suspect are
> very unlikely to be of help to this chap, at the behest of an insurance
> company who are p###ed off at paying out long term on his policy. If
> they he feel he is malingering ( or even just not trying too hard)
> should they not instigate (and pay for) such referrals themselves (
> albeit with my 'permission').