14.9.18

Unprofessional Doctors

Unprofessional Doctors





I first wrote this in response to a post by George Takei about the most unprofessional things doctors have said to patients. I got no response, so I am posting it here. First off, I’m a mutt. I’m a dual citizen: USA and Australia. I don’t feel I understand or fully fit in in either place. So, there will be comparison between the two systems.

In California, I went to see a doctor because my right testicle seemed hard, cold, and swollen. I thought I had testicular cancer. The doc did an ultrasound and said he would call me with the results. Several months later I was informed he wanted me to come back in. I did and waited 3 hours in the waiting room and another 30 in the examination room waiting for the doctor. When he finally came in, he told me he was referring me to a surgeon. I asked if I had a hernia, and he said he couldn't tell me that. I asked a nurse and she said yes. So, the doctor could have told me of the referral over the phone and right after he'd seen the scans. I refused to pay for the visit because he hadn't actually done anything but tell me he was referring me to a surgeon. Because of his delay, and my Medicaid changing on my birthday, I was unable to get the surgery before the fall semester started. The surgeon was away until two days before the semester started. So, I had the surgery and had to walk across campus one tiny step at a time. My first class was all the way across campus, so I was in agony for most of the semester and got a cane.

My first semester at University was painful because of the delay and I developed a fear of knives. Then I lost my wallet and my accounts were decimated before I could report them. This gave me panic attacks which I continue to have to this day. I saw the school shrink and he put me on benzos. I had a number of Medi-Cal/Medicaid shrinks who were just medication oriented. There was no therapy.
I now understand that in the U.S. this is standard, and therapists are separate here.
When I moved to Sydney, Australia, I got my first good psychiatrist who did therapy as well as writing scripts and really seemed/seems to care about my health. More on that later.

The surgery did not take, and I had another one 8 years later (2006), in Sydney. I was told I could walk the next day. Mum was flying in for a major ear surgery I had later in the week, so we walked around quite a bit, but I didn’t feel pain, unlike after the first surgery.

Now I'm facing a third surgery? I now had hernias on both sides. I asked my referring GP what exercises etc. I should discontinue, and he just said not to lift heavy objects "if that bothers you." I responded, "it bothers me sitting down, lying down, and standing up. Then the referral went through and the response from my GP's office was, " we've done the referral,   I don't know what else you expect." I contacted my physiotherapist and she said to ask the surgeon. I finally saw him. Seemed insecure—kept telling me how experienced he was—and, he wasn’t listening to what I was saying. I had already expressed that I was in extreme pain. He did an exam which hurt a lot, but he didn’t seem to care. Then he told me that he didn’t believe I had a hernia and wasn’t sure I’d ever had one. So, 2 doctors in two countries were wrong, but he was right? He also was belittling when he asked how I had surgery in Sydney and I told him I’d lived there for 10 years. He asked how I was able to do that, and I said, “I’m a dual citizen,” but I said the Aussie/British way. I didn’t even realise I was doing it. I repeated (djual) 3 times before finally saying it Dual. So clearly not a very worldly doctor. I felt in a panic and just wanted to get the hell out of there. I went next door and made an appointment with my ENT. He is now assigning his patients to another guy who I’m assured I will like, but I liked my original ENT. The Doctor Chooses you, you cannot disagree with a doctor here, and if you do, your doctor can just dismiss you as a patient. Navigating who will take Medicaid is a nightmare. I was just looking at doctors at the same medical practice but in the south Bay Area, figuring that with bigger population, there would be better doctors. I am beginning to think these bad doctors are a Sacramento thing. But I’m covered in Sacramento, even though the program is state-wide. It’s all very confusing for patients and doctors.
This is nuts. My experience in Australia where I had the second operation was swift and professional. I don't trust US doctors, especially GP’s and it’s affecting my ability to trust at all. The first GP I had upon moving back to California was an older man who was kind and we had no issues, but since then, it’s been one disaster/betrayal after another. I've had so many bad ones in sharp contrast to the good ones I had in Australia. My replacement GP was an arse. I rarely saw him, but he continued to prescribe the same meds in the same dosages until I tried to get off of Xanax. An expert in getting off Benzos had a plan laid out and stressed that the patient must be in control and not forced to decrease dosages too quickly. So, following the advice of my good Aussie Psychiatrist, I asked for a second benzo with a shorter half-life to help ween me off. I explained the whole idea and sent links to the British Expert’s research. And he mistakenly thought I wanted to replace 4mg of Xanax with 1mg of Diazepam. I explained that this was not the case. He got haughty and said he didn’t want to take advice from an Australian doctor or even a doctor out of state. He kept saying, “Do you realize what a tough position you’re putting me in.” I just sat there because I did not know. I shouldn’t be expected to know the inner workings of his practice are. He never explained what the problem was. He expected me to read his mind. He finally agreed to go ahead with the plan if I checked in with him weekly. As I was making the next appointment with full intent to do as he said, My mum called him an arsehole in front of his assistant who was making my next appointment. Well he was. I was having a panic attack for the entire visit with him and he didn’t notice or care.
On my birthday before it was time to send him my weekly report, I got a message from “patient services,” saying that it was not in my best interest or his for me to keep seeing him, thus kicking me to the curb and leaving me with no GP at all. What a nice thoughtful birthday gift. I tried to get another doctor in the same system, but patient services said they weren’t taking “new patients” with Medicare and Medicaid/Medi-Cal. I told them that I was an existing patient but had lost my doctor. They did not help me, the patient. All of my specialists were under the same system as my GP had been under and I liked them.
I found a GP who was only a block away and on our first visit, he said he would write me scripts at my current dosage. When I came back to see him, he claimed he didn’t remember me saying that. I had a friend with me and he did remember him saying that. So, another unprofessional GP.

I finally got another GP at my original provider after mentioning to my eye doctor that I had been looking for one for many months. He said to contact an office and use his name. I got the new doctor and wasn’t quite sure what to make of him. He made me halve my prescription of Xanax, which was fine because A. I wasn’t using the full dosage. It was just in case. And B. I had a lot of pills left from the last doctor who continued to prescribe them for some time after I stopped seeing him, as I messaged him and told him I still hadn’t found a new doctor.

The new GP wanted me to get an American Psychiatrist. And said he would fill my prescriptions for 3 months at half what my earlier ones had been. That was all I was taking anyway. I was wary about yet another stranger doctor.  I'm still in contact with my Australian Psychiatrist whom I trust thoroughly and who does regular sessions with me via Skype for free. I can’t imagine an American Psychiatrist doing that. I was a patient of the Aussie shrink for 10 years though, so maybe he figures he’s been paid enough and money is not as important to him as his patients are. This is clearly not the case in the U.S.A. in my experience.

I was referred to a local shrink by a social worker. I googled him and found out that he was accused of raping suicidal women patients, but the news articles were from 2013, so I naively assumed that the investigation must be over. He had told me he would be ending his practice in Nov. 2017 but would find me another doctor. His receptionist told me the board had shut down his practice, but I had a copy of a handwritten prescription with his license number on it and discovered, on the state medical board website, that he had given up his license voluntarily to avoid some of the consequences for his actions. He had scheduled a final appointment in December at which he was going to prescribe me three-month supplies of my medications but wasn’t able to do that one because he gave up his license. I called the doctor he whose number he had given me.

This shrink made an appointment with me and said he would charge $240 for the initial visit. I forgot what date the appointment was, so I called to find out. He didn’t have a receptionist, only voicemail. He called me back and went on a long rant, as if he were the patient. He was trying to get out of his Medicare contract which forbade him from charging patients with Medicare. Since he was still bound by that, he couldn’t charge me and refused to bill Medicare. He told me to just find somebody else.
So, I was left in the wind again. My GP has been on me to get a new psychiatrist and a therapist. The social worker put me in some database and I went for an intake session, something I’ve never had to do with any psychiatrist before. The place was run very poorly as I filled out page after page after page of paperwork with the same questions on almost every page. I talked to an intern who did my intake, but she was not very bright. I answered all of her questions, but then, breaking HIPPA laws, she went and asked my mum, who was in the waiting area, some of the same questions she had asked me without my knowledge or consent. I really don’t want to go back there. I have found a therapist online who seems nice. I have also heard about a program that does remote therapy and psychiatry including prescriptions and who takes Medicare. I am leaning heavily in that direction but am not sure my GP will be satisfied with that. That I have to please my GP does not make me feel comfortable with him at all. He has written me a prescription for 3.5mg of Xanax a day and I usually need 4. He wants to place the blame on my Aussie shrink: they all do, but it was American shrinks who first put me on benzos, so that just doesn’t wash and does not seem professional at all. I was too afraid to tell him that I wasn’t ok with 3.5mg. I had already tried to titrate down from 4mg a day and it failed epically, even with the help of diazepam. He’s prescribing these meds, but doesn’t understand them. The other women who was a potential new GP suggested by my eye doctor had expertise in anxiety and depression. I was really hoping I’d get her. But it wasn’t my call. I have heard so many seemingly false statements from even the latest GP that I have then discussed with my Aussie Shrink and he informs me that the claims are not valid most of the time, and he doesn’t understand what the doctor is thinking.
          In Australia, the patient chooses the doctor. Everyone gets a Medicare card. If your income is below a certain point, it’s free and you just have to look for a sign outside a doctor’s office to find out if they will bill Medicare. They can always tell you what will and won’t be covered because they have lookup tables… Sadly my last two chosen cities to live in have become unaffordable even with the agreement from both governments that allows me to get benefits from both countries. SIGH. If I could move back to San Francisco, it has universal healthcare. And as I described above, moving back to Sydney would allow me to choose my GP and it would also mean that I could physically see my psychiatrist there.

This is a long tale, but it’s filled with unprofessional doctors who don’t really care about their patients and break the Hippocratic oath and what defines professionalism in medicine. “do no harm,” or as outlined in the Geneva accords of 1948, The health of my patient will be my first consideration.” It seems like such an easy trivial rule, but I have not found many doctors who apply it here.
          I finally saw the potential new psychiatrist today. I had a bad feeling about that practice from the moment I first went in to do an intake, something psychiatrists normally do themselves. I was asked to repeat things multiple times and then again on paper was asked the same questions on nearly every page.
The intake person is in training and not very professional. After I’d answered all of her questions, she went out to the waiting room and, ignoring HIPPA regulations, asked my mother some of the questions I’d already answered.
I had hoped that the shrink might be better. He most certainly was not.
          He had not read the information I had already provided. He started asking me questions, not caring about the answers. He was just going through a checklist. On each answer, he’d say “That’s good.” Good for his checklist, but never mind me, I’m just the patient. He asked about sexual abuse and I said yes… After I responded he again said, “that’s good.”
He asked me if I’d tried certain medications and went through a long list just rattling off names of medications one after the other to see if I recognised them. Then he had me tell him what medications I was on, even though I was asked that at intake, and again by the nurse right before seeing the shrink. I said, “Isn’t that in your file.” He said he had to ask it himself. So, what was the purpose of spending 30+ minutes in traffic for an intake that he never read? He got back to the Xanax and I confirmed for the dozenth time my current dosage. He asked if I’d be willing to titrate, and I said, not at this time. It was our first visit and he didn’t know anything about me or why I needed it. I didn’t get the impression that he was listening to a word I said.
He then told me that, as long as I was on Xanax, he couldn’t take me on as a patient. I said, what about the other medications. Nope. So, you won’t treat me? “correct.” I laughed at the ludicrousness of this. He said “crazy.” He had the information for weeks, but his policy was not to read it before the visit. So, we had wasted another 30+ minutes in heavy traffic to get there. He was an hour late in seeing me, and then said he wouldn’t see me. What a waste of time. Not professional at all!!!
I’ve had it. I can’t deal with these lying/incompetent doctors anymore. No one seems to understand that this kind of thing leaves me paralysed. I am furious and disgusted by this shrink and his staff. They even tried to get me to re-fill out my intake paperwork again after pulling me up on their computers. I had to remind them multiple times that I’d already answered these questions. Psychiatry DMV style, but at least the DMV eventually gets around to helping.

Can anyone else relate or have similar experiences?

TM