What is the Chronic Fatigue Clinic?
The Chronic Fatigue Clinic is a new service offered by Pioneer Health, aimed to assist patients that have been suffering with tiredness for 6 months or longer, with tiredness being of sufficient severity to interfere with their usual daily activities. The clinic is run by Dr David Tadj, who is a senior clinician at Pioneer Health and has a long standing interest in Chronic Fatigue.
How can the Chronic Fatigue Clinic assist you?
Chronic fatigue can impose a considerable disease burden on patients and is frequently associated with significant dysfunction and disability. Patients with chronic fatigue are often unable to achieve their full potential in the spheres of work, home and social activities. Unfortunately, there is no single cure to “fatigue”, as fatigue is a symptom rather than a specific disease diagnosis. The approach taken in the Chronic Fatigue Clinic is to identify the underlying cause(s) of a given patient’s fatigue, and bring about improvement of the fatigue by treating the underlying cause(s) or diagnoses.
Why is Chronic Fatigue difficult to treat?
Chronic fatigue is a clinically challenging condition for doctors. This is because fatigue is the most nonspecific symptom of all. Almost any psychological or medical disorder can cause fatigue. It is for this reason that chronic fatigue can be difficult to diagnose and treat. A screen of simple blood tests (e.g. iron studies or thyroid function) seldom provides the diagnostic information required. This is also the reason why patients with long standing fatigue have often seen a procession of doctors and alternative health practitioners for their fatigue, before presenting for formal assessment of their fatigue.
What can you expect in the Chronic Fatigue Clinic?
In the Chronic Fatigue Clinic patients receive a detailed and thorough assessment of their complaint, to allow the doctor to discover the underlying cause(s) of the patient’s fatigue. This detailed assessment is essential in chronic fatigue assessment and treatment. The assessment takes the form of the doctor taking a detailed history, performing a comprehensive examination and then ordering appropriate investigations for that patient. It should be remembered that 80% of the doctor’s information used to arrive at a diagnosis, comes from the patient history. Investigations, such as blood test and imaging, add relatively little information to the overall clinical picture. Hence the doctor will spend most of his time listening to the patient’s complaint, in order to obtain this important clinical information.
Once this assessment is completed, the doctor can usually diagnose one or several underlying conditions causing or contributing to the patient’s fatigue. Once these diagnoses have been made, the doctor will tailor an appropriate management plan for that patient’s list of diagnosis.
It is because the above process is time consuming and cannot easily be performed in the usual 10-15 minute general practice appointment slots, we have set up our dedicated Chronic Fatigue Clinic. Appointments at this clinic are of 30 minutes duration. Most chronic fatigue patients can be assessed, investigated, diagnosed and provided with a treatment plan over three such appointments. Complex patients may require additional appointments.
What about alternative or complimentary ways to treat Chronic Fatigue?
Many chronic fatigue patients have availed themselves of alternatives treatments, by the time they present for formal medical assessment of their fatigue. The Chronic Fatigue Clinic utilizes an evidence based, best practice medical model. The clinic generally does not recommend alternative or complimentary treatments that are not evidence based. Patients that insist on alternative or complimentary treatments are generally supported in their choice, provided that those alternative or complimentary treatments are safe and not unreasonably expensive.
What about Chronic Fatigue Syndrome?
Chronic Fatigue Syndrome (CFS), also known as “Myalgic Encephalomyelitis”, is a complicated disorder, characterized by extreme fatigue that cannot be explained by underlying medical conditions, lasting for more than 6 months. There are no specific investigations for this disorder. The cause of Chronic Fatigue Syndrome is still unknown, though there are a number of theories as to the aetiology. There are also no specific treatments for the condition.
It is important to realize that Chronic Fatigue Syndrome is very much a diagnosis of exclusion. This means that the diagnosis of CFS should only made after a detailed and rigorous assessment process. It is also our recommendation, that once the diagnosis of CFS has been made for a patient, that this patient should ideally be reassessed periodically. This is because many patients who have been given a diagnosis of Chronic Fatigue Syndrome, including some who have joined CFS support groups, have subsequently been diagnosed with other underlying (, and often treatable) medical conditions that caused their fatigue.
Patients who have been given a diagnosis of Chronic Fatigue Syndrome are welcome to book into the Chronic Fatigue Clinic. Our approach will be to provide these patients with the same detailed assessment described above. Our aim is to carefully assess for underlying conditions that cause the fatigue. Usually such underlying conditions, once identified, are treatable.
What are the Chronic Fatigue Clinic costs to the patient?
The Chronic Fatigue Clinic is a private billing clinic and payment will be expected following your appointment. The fee for a 30 minute appointment at the Chronic Fatigue Clinic is $191.70. A Medicare will rebate of $71.70 applies for patients with a Medicare card. This means that patients will have an out of pocket cost $120 per appointment. For patients with debit and credit cards, Pioneer Health’s Tyro system will conveniently allow for the Medicare rebate to be transferred back into the patient’s account soon after making the payment. The typical fatigue assessment cycle will occur over three such appointments, and will hence represent a total out of pocket cost of $360 to the patient.
How do I book an appointment?
Appointments for the Chronic Fatigue Clinic can be made by ringing one of our reception team members on (08) 9842 2822.