SAME-DAY BOOKING
I read with interest the Practice Management article "Seeing patients sooner with same day scheduling" (March 30, 2006, Vol 3, No 6, page 11) by Abe Konigsberg. How can I get more information about this system and how it works?

Dr Barbara Teal, Hamilton, ON

Abe Konigsberg responds: California FP Dr Mark Murray is widely held to be the father of same-day booking. For more info on the system, check out Dr Murray's useful article "Answers to Your Questions About Same-Day Scheduling" published in the March 2005 issue of Family Practice Management. Though it's intended for an American audience, the bulk of his advice works just as well for Canadian physicians. You can download the article for free by visiting www.aafp.org/fpm/20050300/59answ.html

CFS: AILMENT DU JOUR?
Clearly chronic fatigue syndrome is a divisive issue among physicians. Here's what some of your colleagues had to say about our April 15 poll question, "What do you think about chronic fatigue syndrome (CFS)?":

• I don't really think it's a 'fad.' I think it lies in the functional realm, not the disease spectrum.
• CFS is a fad! Look at the number of 'new' cases now versus two or three years ago.
• CFS is a genuine disease. But diagnosing it is difficult and open for interpretation; hence there are lots of improper diagnoses. We should continue to investigate until we have some more objective way of making the diagnosis.
• My own impression is that these people are often fit, healthy and well motivated before chronic fatigue occurs. They usually have no history of attention seeking or hypochondria. Just because we can't yet explain it in a biochemical fashion, does not denigrate the need to treat it as a pathology.
• Chronic fatigue is a mind/body disturbance that involves some derangement of the immune system. It challenges us to look at the mind and body as a whole. Trauma and stress are often involved; other cases have profound unresolved psychological issues.
• I think there is some evidence that something is going on although I'm not sure that it's an immune deficiency disease. However, it is highly possible. Many patients I have seen with this have been normal, well-functioning people, not hypochondriacs who've latched on to this diagnosis.
• I have a number of patients with chronic fatigue. There is always associated depression and personality factors. I don't agree there is a strong evidence for immune deficiencies but it is a real entity.
• I think it is more likely a functional or psychiatric disorder.
• I actually think the syndrome lies somewhere between a legitimate disease and a fad.
• Chronic fatigue is neither a disease or a fad. It's depression with or without anxiety that isn't treated.
• Chronic fatigue is a legitimate disease, but the evidence is not very convincing.
• How about a third choice: that chronic fatigue is a depressive equivalent?

For the full Poll results, click here.