The current issue of Health magazine features an article "The 4 biggest mistakes doctors make (with women)" quoting liberally from Dr. Groopman, author of "How Doctors Think".
The mistakes are:
1. The doc stereotypes you
2. The doc assumes you’ve got that "bug" that’s going around
3. The doc wants to get you in and out fast
4. Your doc dislikes you – or likes you too much
"While the details may differ, the bottom line is all too common ... and up to half of those misdiagnoses have serious consequences."
Unfortunately, many male doctors stereotype women as high-strung, hypochondriac, depressed ... often without knowing the first thing about the woman or her personality.
A friend (a successful business owner) and I both found ourselves stereotyped by the same doctor as divorcees who wanted a doctor’s complicity in getting lifelong alimony. The doctor never asked either of us the questions that would have revealed that both of us were the primary breadwinner throughout the marriage, or that neither husband was in a financial position to pay enough alimony to pay all our bills, or that we had signed papers permanently waiving alimony and it was too late to change that decision.
We were middle-aged divorcees, so "obviously" our husbands had dumped us for 20-something trophy wives, and "obviously" we were depressed/lonely/unloved and "obviously" out to punish them for making us go back to work for minimum wage after promising we could be housewives. Unfortunately, the only part of that assumption that is true is "middle-aged divorcees". (I don’t know about hers, but my husband ended up with a dumpy woman about my age; hardly a trophy I couldn’t compete with!)
Those questions were never asked, because the doctor stereotyped all divorcees into a single mold. Perhaps his mother was a depressed divorcee who resented being pushed out into the work force again, perhaps his sister cried all the time and couldn’t get a date after her divorce, perhaps he himself was paying huge alimony after running off with a younger woman; whatever the basis, somewhere he got the idea that all divorcees are alike and ignored everything my friend and I said that contradicted his preconceived notion of a woman who’d always been financially dependent on a man and wanted to stay that way.
Fortunately, as the business owner, my friend was able to dictate her own work hours to keep them to a level that didn’t aggravate her injury. She is now healed and back to work because she had flexibility that most employees don’t have and didn’t need a doctor’s note to change her schedule.
One doctor, on hearing that I was married, blamed all my problems on "you resent your husband making you work". Another, on hearing that I was divorced, blamed all my problems on being depressed over the divorce. Clearly it didn’t register with him that my timeline indicated the initial virus occurred when I was single, I relapsed when I was married, and I had now relapsed again when I was divorced. My marital status had absolutely nothing to do with it. And, in fact, many female CFS/fibro patients tell similar stories – whether single, married, or divorced, doctors tell them that their condition is caused by unhappiness with that state, and theoretically would be cured by getting married if they aren’t or getting divorced if they are. Well, I got married, and I got divorced, and I still have CFS even after almost 10 years of being blissfully single.
The article suggests "Try a female doc. Studies show women do a better job of encouraging patients to talk" according to Prof. Debra Roter of Johns Hopkins. In fact, many CFS/fibro patients have found that female doctors are more open to accepting a physical basis for their ills, rather than stereotyping them as hypochondriacs or nut jobs. Female doctors know that not all women are stupid, depressed housewife wanna-be’s ... they just need to look in the mirror to see that stereotype is wrong. And, in fact, when I was able to get a female doctor, I was taken seriously. Unfortunately, there aren’t enough female doctors to go around, and some medical groups in this area restrict their assignment to those patients who for religious reasons are not allowed to see a male doctor. Since I have no such religious limitation, they would automatically assign me a male doctor, even though I asked for a female. (And, no, I wasn’t about to go out and buy a new wardrobe and change my name to fake being part of that religion.)
Tracy Gaudet, MD, author of "Consciously Female: How to listen to your body and soul for a lifetime of healthier living" finds that most women stick with an unhelpful doctor too long. She recommends if the doctor "belittles you, acts defensive, or flat-out ignores your requests for better dialogue" you should immediately look for a new doctor, and tell him precisely why you are changing. I’d say that any doctor who blames your CFS/fibro on your marital status is certainly belittling your concerns and deserves to be dumped.
When I changed doctors, I consulted a friend who is a nurse practitioner, how should I present my reasons so that they wouldn’t think I was doctor-shopping to get drugs? Knowing the entire story, she edited it down to "my last doctor’s office doesn’t return phone calls" as a perfectly legitimate reason that any doctor would respect.
The article suggests checking www.ratemds.com, and investigating your final choices at www.docinfo.org (there is a fee). "But remember that a spotless record won’t guarantee good communication skills."
Nor will it guarantee that there haven’t been complaints. I filed my first complaint about one of my doctors as soon as I realized that his staff had no intention of ever letting me make another appointment with him (it’s unethical to abandon a patient), and made more written complaints with the Medical Board as more information came to light. Yet, even though I know for a fact that multiple complaints were made because I’m the one who made them, the Medical Board shows that he has no complaints; they kicked back every one of my written complaints with a form letter that I hadn’t lost life or limb, therefore, they weren’t going to do a thorough investigation. A million other women could’ve had the same experience my friend and I had with him, and the California Medical Board would continue to say he had no complaints ... until he finally kills someone. I can’t point to a mangled or erroneously amputated limb, only to a lifestyle lost. Losing my health and my career simply wasn’t egregious enough to merit a black mark in his record.
So, I’d recommend checking one more place: your County courthouse, where there is no editing of what complaint is considered worthy of being listed in the records. In some places, you can get all the information you need online. If your county isn’t one of them, go to the Civil clerk, and ask for the case index. Look up the doctor’s name (and even the name of the medical group) in the Defendant/Respondent section, and if he’s been sued, start taking notes. The case index may indicate the names of the lawyers, which is certainly an easy way to get information – call the plaintiff’s lawyer, and ask what he can tell you about the case. Some are innocuous (one of Mom’s specialists was sued without having any part in the patient’s care; the lawyer named absolutely everyone whose name was on any piece of paper the patient had and sorted them out later) or maybe a landlord suing the responsible parent for a college student’s unpaid rent, and some will be surefire warnings to stay away.
If the plaintiff’s lawyer can’t or won’t tell you anything, ask to court clerk how you can get the case files and read the contents. I spent the money to file a lawsuit without a lawyer just so that there is a public record of what happened to me; the case was dismissed because of statute of limitation problems, but the facts are now out there to warn other innocent people away before they become victims of lying and incompetence.
And, of course, talk to other CFS/fibro patients in your area about what doctors they’ve found helpful and which they had problems with. Unfortunately, when I called the president of the support group I knew about, she had only one recommendation – the doctor who was never taking new patients. When I said I’d been trying for years to get an appointment with him, and who would she recommend in the meantime, she simply repeated his name, which did me no good, because he still wasn’t taking new patients, and wasn’t right up till the day he retired.
Eventually, a friend googled up a second support group in the area, and the president of that one simply groaned when I told him which medical group I’d gone to after my long-time PCP died suddenly – he was (to put it mildly) irked that the other person hadn’t at least told me to stay far away from them, because they were well-known in the CFS community as being the last place you’d want to go; he’d heard my tale of woe a dozen times before from other patients, who didn’t have the legal background to make a public record the way I did.
If you can’t find a support group in your area, Co-Cure.org has a Good Doctor list – these doctors are not all CFS/fibro specialists, some (including mine) are simply "CFS friendly", i.e., not inclined to slap a psych label on you. Check the various online forums, too, for e-groups – CFS_Facts-subscribe@yahoogroups.com will get you to mine – where you may find someone in your area who has some advice on doctors worth seeing (or worth avoiding). My current doctor is not a specialist, but he’s open-minded enough to read what I print out for him, and discuss the pros and cons of any medication or test recommended in that printout.
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