PATTERNS OF UTILIZATION OF MEDICAL-CARE AND PERCEPTIONS OF THE RELATIONSHIP BETWEEN DOCTOR AND PATIENT WITH CHRONIC ILLNESS INCLUDING CHRONIC FATIGUE SYNDROME

To what extent do personal constructs affect the relationship between doctor and patient when the ill patient does nor readily recover with treatment? Questionnaires were returned anonymously by 609 patients wi th a self-reported diagnosis of chronic fatigue syndrome, who were con sidered chronically ill. Findings were compared with those of an earli er study of a population of 397 general medical patients. The chronica lly ill patients lost an average of 65 days of work per year due to il lness compared to general medical patients who missed six or fewer day s per year because they were ill. The chronically ill patients also re ported a 66% higher frequency of iatrogenic illness, spent more money on health cart, took more medication, saw more specialists, and were m ore litigious than the general medical population. Re search suggested several patterns of relationships between doctors and patients, and a ttitudes to health and illness, which may alert doctors to patients' p erceptions, beliefs, encoded constructs, and patterns of relating that affect responses to treatment. More attention by doctors to patients who are experiencing the stress of chronic illness is indicated.