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I'm in the process of being judged by a doctor and I know the doctor will be judging me for having a mental illness, not to mention my mental illness treatment. This is happening because I just put in an application for a new general practitioner (GP). On the application, I had to write down my medical conditions, medical concerns and all medications being taken. As I looked at it all, I knew it didn't look good for me. It's funny that having a serious mental illness makes you appear like a less-than-desirable patient seeing as you're one of the people who actually need help more. And that's because of judgment. It's about a doctor judging you for your mental illness and your treatment. It's unfair, but it definitely happens.
Unfortunately, where I live, there is a huge shortage of GPs, so many people don't have one. I lost mine last year when she retired. So now, when a doctor agrees to take on new patients they get their pick of who they want.
Now, to be fair, I don't actually know what the doctor will be judging me on, but I know the doctor is judging me. The receptionist said she will call me "if I am accepted."
Yup, they sure do. I was really lucky that my last GP treated me like a regular human-type person and not a "crazy" person. This is not always the case, though. Often, as soon as a doctor sees the dreaded "mental illness" on your chart, everything you say is suspect and you must be an addict and drug-seeking. This happens absolutely every day. (For whatever reason, it seems to be worse in emergency rooms.)
But what's worse, perhaps, is that doctors judge based on mental illness treatments. For example, if you take a benzodiazepine (like lorazepam [Ativan] or alprazolam [Xanax]), which is a completely reasonable treatment for some people, some doctors won't see you, period. I've had two doctors reject me over the years because of my mental illness treatment. What doctors don't seem to understand is that the more complicated the case, the more complicated the treatment, and the more standard "rules" one may break. That's pretty normal in a hard-to-treat case of serious mental illness like bipolar disorder.
I remember one doctor, years ago, refusing to see me because I took sleep medication every night. She was aggressive and bitchy about it, too. Apparently, if it were up to her, I would just never sleep again. Empathy -- some doctors don't know the meaning of the word.
And what these judgy doctors fail to realize is that it makes the patient feel even worse about themselves. It's hard enough to maintain positive self-worth as a person with a mental illness without being judged for this mental illness by a doctor -- one of the people who are supposed to help.
And even worse, patients tend to question their own mental illness treatments in these situations. Now, it's not necessarily a bad idea to question your treatment. If it isn't working for you, then, yes, questioning it makes sense. However, this questioning should be an in-depth conversation with the prescribing physician, not a snap decision to flush your medications based on a judgment made by a general practitioner about a treatment prescribed by a specialist.
I respect a doctor's right to work with patients with whom they think they can help. I also know that some doctors aren't comfortable with some treatments and so don't want to work with patients on those treatments, and maybe even this is okay. But I think the problem comes from how it's handled and what happens next. For example, if the doctor sits you down and thoughtfully and empathetically explains their reasoning and says that while they don't work with that treatment, it still may be right for you, that's one thing. Simply rejecting you, is quite another. If the doctor provides a referral to someone who can help you after admitting they can't or won't do it themselves, that's one thing. Leaving you with no one is quite another.
The thing is, making that responsible choice and actually helping the patient instead of merely judging them and pushing them out a window means the doctor has to do more work and actually admit that different doctors treat people differently. They have to be able to deal with their own fallibility. I don't find doctors are awfully good with that.
I wrote this to remind myself that being judged by a doctor and then, ultimately rejected, is about him and not me. If a doctor judges me unworthy, then so be it. I suppose he is unworthy of me, too.
The important thing is to make sure it doesn't impact self-worth and doesn't change your treatment without a consultation with the prescribing physician.
I get it; my medication load is challenging, and no one wants to deal with a "crazy" person, but I fundamentally believe that if a doctor is in the business of helping people if they truly are a healthcare provider, then they will want to help me, regardless. And if not? Fuck 'em. I know what I'm doing. I know what's right for me. Their judgment isn't.
Natasha Tracy is an award-winning writer, speaker, advocate, and consultant from the Pacific Northwest. She has been living with bipolar disorder for 26 years and has written more than 2000 articles on the subject.
Find more of Natasha’s work in her acclaimed book: "Lost Marbles: Insights into My Life with Depression & Bipolar" on Amazon.
Connect with Natasha at the social media links below.
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I absolutely agree with being judged by doctors, once you’ve disclosed to them that you have a mental illness. Though I have a great PCP, and have not with him nor past PCP’s, felt at all judged- my experience comes from the ER. As soon as the attending physician, PA, or nurse see those words “Mental Illness”, and the list of psych meds- depending upon your cause for being there, you become devalued.
This happened to me in April of this year. I had been sitting on my couch, not doing anything really, when I suddenly began having double vision. I attempted to stand, though fell back to the couch. Within about 15 minutes, I began having tremors- my hands and arms, and my legs. I called my ophthalmologist to request an emergent appointment. I was terrified, which of course brought on an anxiety attack. I called my daughter, and asked that she get permission to leave work. Thank goodness for SIRI- as I otherwise would have been unable to call anyone.
My ophthalmologist did an exam, and determined that my eyes were not causing the double vision and directed that I go to the ER.
I was brought right away to an exam room at the ER. A PA came in, asked my cause for being there, then proceeded to take my medical history. Mental Illness & long list of psych meds. As he was documenting all my info, a nurse was attempting to start an IV line- which was proving difficult due to the severe tremors. With the assistance of another nurse, she was able to finally get it in. Once they left my side, the PA came to me and actually spoke these words, “You can stop your tremors if you want to” I asked him how I was supposed to do that, and he nonchalantly responded, “Oh, you can do it” I was doomed. Bring on mire anxiety.
They did bloodwork, and a CT Scan was attempted, though I was unable to keep still. They got one eventually, after a heavy dose of Lorazepam kicked in. I was there for 8 hours. My vision had gone back to normal after about 6 hours. The PA told me my bloodwork was all fine and that since my vision was no longer an issue, that I was all set.
A few days later, I received a text from the hospital, indicating that I could view my reports on the Patient Portal.The PA had actually documented that only when he or the nurse were with me, did I have tremors- and that I stopped having them when alone in the room which is very untrue. My bloodwork wasn’t fine either. Four of the tests were flagged as being well below or above range. My PCP referred me to a neurologist, and thankfully, he has been able to make a determination and begin treatment.
This unfortunately, was not an isolated ER experience. I go there seeking medical attention, and instead am stigmatized. I have already, a stigma about myself personally, which I have not yet been fully able to work through.
These two quotes come to mind:
“Judge not others, lest you be judged”
and
“No one can make you feel inferior without your consent’
Nuff said
Sorry, I keep giving you an incorrect link
but this one should work . It’s a link where you can view patient ratings of drs and also find out if they are taking on any new patients
https://www.ratemds.com/about/
Maybe a team member from the CrestBD group could help you in your search for a good quality Dr. In turn perhaps you could reciprocate by being of some assistance to them
https://www.crestbd.ca/about/team/
Here’s alink to what MDA has to offer
https://mdabc.net/psychiatric-clinic/adult-psychiatric-clinic/group-medical-visits/
You can find patient ratings of BC Drs at
http:\\ratemds.com (general website, you’ll have to drill down further
Here’s a link that may be useful
https://bccfp.bc.ca/for-the-public/find-a-family-doctor/
Or maybe this one
https://www.ratemds.com/bc/
What about trying a virtual dr from an on-line clinic in the meantime?
https://www.virtualclinics.ca/?gclid=EAIaIQobChMIotzS74ec6wIVfT2tBh2xuwZREAAYASAAEgLpvfD_BwE
The Mood Disorders Assn might have some suggestions for you
Perhaps your local university may be of assistance in setting you up with a newly minted dr?
Many drs start off rotating as locums for other drs (subbing) until they can establish their own practice. It’s a way to get to know a few different ones, build a rapport with the ones you clique with as they work toward building their own practice someday.
For me I find it works best if you can find a doctor who shares office space with at least one other dr. If one retires, as mine did, it might be easier to get in with the other one
Good luck with this, Natasha. Getting a doctor, for ANYone these days, is no picnic.
Empathy is is two way street
The suicide rate among Drs is double that of the general public according to Statistics Canada. Stress & burnout are major contributing factors.
https://www.google.ca/amp/s/www.cbc.ca/amp/1.5124070
Many are reluctant to disclose their own mental illness for fear of repercussions
https://www.google.ca/amp/s/www.psychologytoday.com/us/blog/humanity-in-medicine/202002/why-doctors-avoid-mental-health-treatment%3famp
Even before the COVID19 pandemic Drs were known to work ridiculously long hours (either school or on the job) without adequate rest. Imagine trying to do that depressed and worried about the repercussions if they disclosed their own illness. Not to mention the grief and trauma they face every day
My guess is that for many it’s an act of self care. Maybe even denial on the part of some regarding their own mental illness. Perhaps we act as a mirror, a reflection of themselves they’d rather not see
I can totally relate to this article.I currently have not had a GP for over 6yrs and have yet to get into a Gyno office.As soon as the dr office seems the online form listing my meds I know im doomed.I get the polite the dr is not currently seeing new patients. Then I hear other people who just started to see them.In the past year I have gone to a medical walk-in for a cold. I simply listed not taking any medications and listed no health issues. Last thing I want is to lose the ability to get in to a dr if I were to be sick .
Hi Erika,
I’m so sorry. It sucks that we have to result to lying to get treatment. That says so much.
I must say they’re not all like that, but finding one that isn’t can be awfully hard.
– Natasha Tracy
Sadly, in most jurisdictions, doctors aren’t supposed to be allowed to do this (though there are legit ways to limit their practice as you note). There are practice standards all about this published by the regulatory colleges (in BC, it’s called “Access to Medical Care”). But with pathetically weak college enforcement processes combined with processes that make complaints extremely difficult to bring forward, it’s trivial for doctors to ignore these and do what they want, with no consequences. That’s even before the supply-and-demand issues kick in.
I disagree that fear or unwillingness to admit fallibility is behind this. Most start out idealistic, wanting to help, etc. and then eventually all the shit that is the medical system grinds them down, they get burned for trying to do the right thing, see their colleagues who provide shitty care but are taking home twice the pay with less effort and hassle, and eventually their attitude becomes “fuck you, why should I go out of my way for you… not my problem”. (Some take way less grinding than others to get there.)
But yes, fuck ’em. You can’t be a shitty human being and pull off the moral-superiority, make-me-feel-bad-about-myself thing simultaneously.