In the case of lupus, the problem of diagnosis may be a major one for the doctor. Most physicians in general practice do not see many cases of lupus and may have difficulty recognizing it. Physicians do not want to label anyone as having a serious disease until they are certain of the diagnosis. They may therefore order a great many tests before committing themselves to making a diagnosis, thus inadvertently adding to their patient's burden. While the doctor is pursuing the diagnosis, patients, unaware of the doctor's dilemma, may feel that not enough attention is being given to their complaints and fears.
Problems can also occur between the doctor and the patient with lupus over the issue of treatment.
The physician may feel that because the patient's lupus has developed life-threatening complications, it is necessary to prescribe steroid or immunosuppressive drugs such as those used in the chemotherapy of cancer. These treatments have undesirable and dangerous side effects which must be explained to the patient. Such an explanation may cause the patient to question or even to refuse treatment. The physician must then reinforce the fact that the disease itself, if it goes untreated, can result in more harm and discomfort than the treatment. Unfortunately this discussion, while helping the patient to understand the problem, may serve to increase the patient's fear and anxiety.