In the world of doctors and patients trust is a key component when it comes to diagnosis, treatment, and overall care. However, trust is a two way street. The doctor must trust the patient and the patient needs to trust the doctor. This is a relationship that can take time to form and develop, but what happens when you are working with a medical system that trains it’s doctors to never trust their patients? That is the system we are working in and it has created a monster of a medical industry filled with millions of un happy, mistreated patients, mis diagnosed patients, and doctors who believe they know all and are god’s gift to the world. We have entered an era of medical practice where the patient is no longer valued as a human being, but as a liar seeking attention, or someone who has something to hide, basically an individual that does not really need medical attention unless they present symptoms of death, and even then they probably would doubt the patient!
A friend of my husband is in his residency after recently completing medical school. My husband and I have greatly enjoyed hearing all of his exciting and hilarious stories of the encounters he has endured during his time in med school and residency. One thing that has stuck with me since he started was something he was told on his first day of medical school. Mind you this is what is being told to all the medical students of the next generation. The generation in which I feel we can really make an impact to change the way our system works. In the classroom full of students (as I imagine it), the minds of the future are told “Rule number 1: never trust your patient.”. Wait.. what? That’s right. That’s rule number one. Never trust your patient. I have to say it more than once because I just cannot believe that this statement is even spoken anywhere in the medical world. Do not trust the person that is seeking your help, and guidance, and treatment to get well. My assumption is that many doctors started out going into this profession specifically to help people, so imagine my surprise that in their training they are being told not to trust them. A HUGE component in the achievement of proper treatment. Yet, here I am putting my life in the hands of tens to hundreds of medical professionals wondering why it is so difficult for me to receive proper treatment? Why I need to see so many professionals to just figure out what I have and how I can treat it, only to find out when I walk in they were taught to not believe a thing I say. On top of that being a woman already sets me back with these encounters. The amount of appointments I have had where doctors have written me off as an emotional female who exaggerates her experiences is mind blowing. The statistics are out there. Females have to make many more trips to reach diagnosis than males for this very reason and here we are discovering the battle is twice as hard as we originally thought! To make matters worse after being through everything that I have I now to go in with the same mindset when I see any doctor. I don’t trust a word he/she says until I get several opinions that agree or until they can prove it to me. But when am I to know that they will ever believe me? It’s this never ending cycle of mis-trust. The doctors mistrust quickly turns into the patients mistrust and it keeps going and going and going. Where is this cycle to stop? I have less than a handful of doctors that I know have trusted me from the beginning and they are the ones I have stuck with as my life long specialists. Even then, I still am surprised by the things that happen in the walls of doctors offices. A perfect example is my encounter with the Emergency Room doctor I mentioned in my previous post. ER doctors, of course, are the worst of them all in all aspects, but you all know my opinion there…
When trust is not there doctors just write you off and will not go the extra mile to ensure you have the best patient care. A perfect example is an incident I just had this week with my pain specialist. I have been with my pain specialist for over two years now. He has recently taken another job in another state. I was bummed to hear this but now would be seeing his partner. I go in every two months as required to receive my pain medication prescriptions (tramadol to take daily and refill my hydrocodone every 6 months as I only take for kidney stones). The new doctor is well aware of my medical history and knows it is a life long condition. I had my first appointment with him two months ago just to review my history, he wrote my Rx’s and all was fine. This week I go in and he asks me “Well I need to know what your prognosis is?”. I was confused as he has all the information but I walked him through everything… that my kidney condition is and will continue to get worse and the EDS as well has been progressing with joint pain and issues. I was just getting the tramadol refill this round. He asked if I am taking it every day, and I said yes. He asked if it helping and I said yes, it has been and I’m glad because I wanted to remain on a lower level drug. He then explained to me that this is now a level 3 drug (whatever that means). He tells me that his policy is not to treat pain he cannot cure, and since this is a life long thing I need to just find one of my regular specialists or primary care physicians to prescribe me my medications going forward. He basically just wrote me off because he didn’t want to treat me anymore. How is it not his policy? He is a Pain Management Specialist!! What the fuck. I still don’t get it and if I wasn’t taken so aback about these comments I should have fought back and said exactly that. Bottom line it makes no sense to me. But I don’t want to be treated by someone that doesn’t want to treat me. In that moment he lost all my trust and respect as a doctor and he should me ashamed. He wrote my two month Rx and said that should give me plenty of time to find someone else to write my prescriptions for me. “Anyone can write them” he said “they usually just don’t want to because then they can be flagged”. This is how our conversation ended to which I realized, oh great, so not only are you being a dick because you don’t want to treat me but now you’re going to make it really hard for me to find someone to write me my medications to treat my chronic pain. WHAT A GUY! Doctor Douche of the year for sure. Every time I think nothing could surprise me anymore with the way I am treated as a patient, something new like this happens and I am completely blindsided with how arrogant, pig headed, and inconsiderate doctors have become. Where has the doctor of the old days gone? Where has the proper care and respect and the Drive to help people gone? It’s been lost in modern medicine and modern mentality in the doctors of this generation.
This trust factor extends now even beyond the walls of the doctors office, hospital walls, and patient waiting areas. Not only are we facing an epidemic of mistrust with doctor patient relationships but also of doctor-insurance-patient relationships. I recently needed to have an upright MRI as with the dizzy spells and other symptoms I have been having that brought me to the ER my doctor suspects a brain slump. This can be very difficult to image and diagnose and as he said “in general with the conditions you have imaging is difficult because it’s all still images and our technology is not up to par yet to get a good look at allot of things within the human body”. He made it a stat MRI so he could get right with the Chiari Institute and said to get it in within 2 days. My appointment was made and I received a call the morning of the MRI which was scheduled for that afternoon. The insurance had not been processed because they deemed it not medically necessary and required further investigation. They contacted the doctor and he explained why this needed to be done and they still disagreed (even though they are not the medical professionals) and said further investigation would be needed and would not cover this MRI. I was livid. I was not going to allow an insurance company to determine what tests I needed so I showed up for my appointment and asked them how much. It was $600. “Fine,” I said, “I will pay for it and send the bill to the insurance company to reimburse me”. The manager of the place knowing the background of the situation said “tell you what, I’ll make it $400 for you and you only have to pay half today”. She said she had seen this way too often and would do whatever she needed to help. It was very big of her and I was beyond appreciative.
I still cannot believe this happened though. Since when has our system become one where the doctors’ opinion is no longer valued as “what needs to be done” but the insurance company can decide whether or not the person they insure should receive certain tests/medications/ etc?! It’s completely outrageous! It this circle of mistrust between patient, doctor and insurance company who is the professional? I didn’t go to Cigna for health care, I went to my doctor. The person who has been well trained in the practice of medicine and knows me and my disease. Mean while the company I pay to insure my health is now given the power to determine if I need this care? How did this happen? When did they become the experts? It goes back to the old saying Money is Power. And who has the money? Cigna, United Health Care, Blue Cross Blue Shield (the worst of them all), Aetna, you name it. They all carry the key in determining your medical fate. Should they decide you don’t really need that cancer treatment, you may be faced with the choice of receiving top quality care and going bankrupt or mediocre care that you can afford but may not cure you or treat you properly. I cannot fathom how we have gotten here, but it is a place we need to escape and fast.
How are we going to break these barriers, especially when the latest generation of doctors is being taught to treat their patients this way. At first, my thought was well, it needs to start with the doctors. They have to start changing their practices and their mindsets. Of course, how can we even accomplish this from the patient side? Then I realized, maybe we CAN stop it from the patient side. Yes, we can. It almost requires a bit of a “patient movement” of demanding better treatment from the medical professionals that are supposed to be caring for their patients, treating their patients, trusting their patients. Not kicking them out of the door while they line their pockets. It’s our time. Time for us to fight back. Time for us to stand up to our medical professionals and demand better care. Time for us to let them know we will no longer tolerate their mis treatment. Their job is to serve us. Wearing a stethoscope does not give them the power to mis-treat us, write us off, or ignore symptoms we are trying to bring to their attention. Without us they have no business. And that’s exactly where it begins. Giving business only to the doctors that treat patients the way they are meant to be treated and taking away business from the doctors that do not. It’s a small step in the right direction but one I think can make an impact on this long road we have ahead of us.
We are so programmed to not question how our doctors treat us, and diagnose us because we have been brought up to know a doctor as an authority. When they start taking advantage of this authority there is a problem and we cannot allow for this to stand any longer. The best way I know we can address this is to put the doctors that treat patients this way out of business. It’s just the start of the movement but we have to start somewhere. It’s time to reclaim what medical care should be in this country and if it’s not going to start with the doctors, then it needs to start with the patients. I have kicked off this process and I intend to post on my blog page a list of recommended doctors and a list of doctors to stay away from. I will post location as well for anyone in my area but if we get more folks to do this in their areas and raise awareness for doctors that are mis-treating their patients across the states we can make a big impact. I encourage everyone to do the same and bring awareness to your friends, family and more. It’s time to fight for our relationships with our doctors, show them that trust goes two ways. It’s time for us to be treated, not mis treated. It’s time to re-build these relationships and only then can they begin to earn back our trust and we can gain theirs.
~Just A Regular Sick Girl
One thought on “Trust & Mistrust : The Medical Industry Epidemic”
You have hit on a lot of issues that I have been studying for quite some time now. I’ve been through good visits, where I feel validated for going to the doctor and seeking professional opinions. And I have had bad visits, where the answer was “we’ll just wait and see what happens” because there was no immediate answer to my issues. Doctors seem to especially struggle with chronic conditions where there is no cure and no chance that the issues will just “go away”. Part of that is the existence of patients that really do abuse the system and monopolize a doctor’s time and resources. But you are right, it is a two way street, and doctors do have an obligation to earn your trust.
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