The State of Headache Medicine in Canada: Q&A With Elizabeth Leroux, MD

President of the Canadian Headache Society, neurologist and migraine advocate Dr. Leroux discusses migraine stigma and access to care.

The American Headache Society thrives because of its diverse membership and its partnerships with other professional headache societies. Canadian Headache Society President Elizabeth Leroux, MD, is a neurologist and clinical professor of neurology at the University of Calgary. In an interview, she shares her insight about headache medicine in Canada, the stigma surrounding migraine and what we can do to inspire the next generation of headache medicine practitioners.

What is the current state of headache medicine in Canada?
I would say there’s a lack of access to care for patients because there is a lack of education for healthcare professionals. Family practitioners are not trained to diagnose and manage headache disorders; they rely on neurologists, but neurologists are not well-trained either. Everybody wants to see a headache specialist, but wait times can be between one and three years. We need to train all doctors better so more patients can access care.

What initiatives are needed to attract young professionals to the field and support them?
Headache treatment used to be the last priority for neurology, but now it’s an exciting field. The Canadian Headache Society wants to help young neurology residents discover the headache field and lead successful careers. We need to show them how we can help patients—we’re so passionate about headache care because we see patients getting better and how it makes a difference in their lives. You need exposure in the clinic; you need young professionals to understand the science behind headache symptoms. I think this is what’s currently missing in neurology training.

What accounts for the stigma surrounding headache?
I think headache is stigmatized because it’s still a very subjective and invisible condition despite the fact that we have scientific knowledge about this neurological disease. Pain conditions are stigmatized because they are seen as psychological, which is completely wrong. I think we need to work and to demonstrate that headache is part of neurology, that it can be treated and that it is an exciting practice.

What hurdles does headache medicine face in Canada?
The state of education—and the resulting lack of care—are definitely hurdles for Canadian headache medicine, as is the stigma that surrounds headache in general. Canada’s public healthcare system also presents a challenge—it’s a provincial system, meaning that making changes on a national level is quite difficult. All of us in each province feel as though we have to focus on local issues at hand instead of uniting as a society to call for more widely diffused change.

Why is it important to have professional societies that support those in the field of headache medicine?
Having a society allows you to build a community, and meet people who have the same interests and experiences as you. You get to exchange ideas, feel supported and ask questions when you have a difficult case or when you want to start a research project. Without a society we wouldn’t have fellowships, guidelines or headache courses. The Canadian Headache Society is a small society, but I think it has achieved quite a bit and I hope that it will achieve more.

How does the Canadian Headache Society directly or indirectly affect people living with migraine or other headache disorders?
We train doctors, which increases the chance that every patient in Canada gets to meet with a properly trained doctor so the headache disorders can be better diagnosed and managed. We hope that every young physician we train will be able to impact thousands of lives.

Elizabeth Leroux, MD, is a member of the American Headache Society, a professional society for doctors and other health care workers who specialize in studying and treating headache and migraine. The Society’s objectives are to promote the exchange of information and ideas concerning the causes and treatments of headache and related painful disorders, and to share and advance the work of its members. Learn more about the American Headache Society’s work and find out how you can become a member today.

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