Saturday, January 24, 2009

Warning: Rant Ahead

But it's not about politics. Well, sort of. It's about the politics of being a victim of the American medical system. I'm healthy, so I know it could be worse, but I'm livid over my first physical with my new doctor.

First a little background. As I said I've enjoyed very good over-all health all of my life. My visits to a doctor have been mostly limited to annual physicals and one pesky ailment: chronic UTIs (urinary tract infections), which are not unusual in women because our urethra is so close to the vaginal opening, causing bacteria to creep into our sweet spot and make us miserable. If you've had a UTI, you will understand how exasperating it can be - it's not only pain but a type of discomfort that makes me, anyway, feel like I want to crawl out of my skin. I will take a toothache any day over a bladder infection.

My gynecologist, Dr. P, and her entire staff are absolutely wonderful. But because UTIs are not considered a gynecologic issue, they cannot treat them. The primary care physician is charge of my urethra and bladder.

I had the same primary care physician for over 15 years - Dr. L. , who was a really, really good guy. He listened and he partnered well with me when I pushed an issue. He retired two years ago and I was assigned to one Dr. Smith, a very young doctor who could multi-task like nobody's business and always seem to hear what I said even if he had his nose in his tiny computer and was tap, tap, tapping away on it. This young doctor, for the first time in my medical history, prescribed for me an antibiotic that I could fill ahead of time in anticipation of a future UTI. It was a quick run - six pills in all, and after the first day of treatment, the symptoms were gone. And, I could refill it several times before seeking another prescription. So no more having to wait until morning to call the doctor, missing work to go in for a urine sample, getting the prescription filled and waiting for it to kick in. Beautiful. I loved Dr. Smith. Well, Dr. Smith beat feet back to Ohio where he came from.

I am now assigned to a certain Dr. R, another very young doctor with the bedside manner of an icicle. They didn't teach herhow to smile in medical school, apparently. She asked all the right questions but didn't want to hear any elaborations. Sensing this immediately and disliking it, I turned a bit passive-aggressive and gave her longer answers than she wanted. This caused her to cut me off and tell me that "I need to talk now", rather rudely, I might add (for which she apologized later). I may have deserved it, I'll admit it but even though I admit to doing it, it is my nature to be detailed when discussing most things. In fact, I'm very articulate when speaking, particularly on issues that I know and understand well: in this case, my body and my health. Well, Dr. R would have none of this.

Now what I'm really fired up about is this: you know that great preventative UTI treatment that the wonderful Dr. Smith prescribed for me? I told her about it and she refused to continue it! That is what I'm so pissed off about. She told me the following: "I cannot do for you what I will not do for my other patients." To which I replied politely: "But every patient is different, with different needs and this has worked extremely well for me. Due to this treatment, I have not suffered for hours or missed work because of a UTI." She would not budge.

I'm now back to the dark ages again with the UTI situation. When I have symptoms, she expects me to call her office, come in for a urine test and get a prescription.

Dr. Smith had explained to me how archaic this was and why, while he tap-tapped on his tiny laptop, with the toes of his polished wingtips peeking out from behind his very neatly pressed rayon trousers. He said that a urine test will almost always reveal one of two possible types of bacteria that cause such infections and that the antibiotic he prescribed took care of either. So why put a woman through the agonizing postponement of treatment? Dr. Smith, why did you have go away???

I've been really angry over this. Firstly, Dr. R's manner and condescension. Her message was clear - you're the patient and you don't know anything and I'm the doctor who will lord over your body because I know best.

Needless to say, I'm going shopping for another doctor. Wish me luck.

20 comments:

  1. I would absolutely get another doctor. Either she is just rigid or she is trying to cover her ass in the case of a misdiagnosis on your part (which is unlikely). Even my woman doctor is a little bit elastic in her ways - and I thought mine was bad. YOurs is horrible.

    ReplyDelete
  2. i would too- or try to find a nurse practioner. i don't know what the rules are in your state but i never go to an md. never. my mother had a similar experience and i would never take her back to another md. ever.

    i generally go to a walk in clinic for minor things simply because those folks tend to play god less.

    ReplyDelete
  3. Kenju: Thanks for confirming my own feelings. I appreciate your comment a whole lot.

    Betmo: I could see the NP but she works under this doctor which I suspect means she has to follow the same protocols. I'm pretty sure about this.

    Walk-in clinic? We have no such thing around here and this is a state where health insurance is mandatory now.

    ReplyDelete
  4. I have had this problem for a long time now. I finally found a nature treatment that will take care of it though so that you do not need antibiotics anymore. It is a sugar that the bacteria love and they attach to it in the UT and are flushed out. Of course I drink more cranberry juice than anyone I know because that helps, but what you need to get is D-Mannose. I bought mine at a health food store and have only had to use it a few times but it DOES WORK!

    ReplyDelete
  5. Oh, how I do relate!!! I've been fighting with doctors it seems for years, not only for myself because I have been quite healthy for most of my life, but for my kids and believe me when I say that I have some nightmare tales! I hope you find another good doctor soon! I do have a good one now, but boy, are they few and far between!

    ReplyDelete
  6. Fire her! but make sure to tell her why - in a letter that she can ponder since she clearly is listening challenged

    how absurd to cost the system more money and cause you more discomfort - makes me wonder if she's paranoid for a reason

    I love my primary doc - problem is my health insurance cut me from being a small business when I had to lay off my staff and since I'm always late paying the $980 a month for an individ policy I am now un-insured! God Bless America

    ReplyDelete
  7. Finding a medical practitioner you can relate to these days is a difficult task. I spent 8 years working in a urology practice with 6 physicians only one of whom specialized in treating women. Liberality may have the best idea but you may have luck in finding a sympathetic urologist in your area.

    ReplyDelete
  8. Liberality: I will definately try what you suggested. Absolutely. Does it come with instructions? If not, how do you yourself use it? Cranberry juice, which helps many women, has never done squat for me. And I don't like it. Drinking a lot of water helps, so I try to do that but it takes about 40 oz of water a day for effectiveness (for me) and most days I don't meet that with water - I'm a teacher and getting to the bathroom all the time ain't easy,especially in the little building they call the school. We one, single stall closet, the size of a phone booth for up to 21 staff members to use daily. The other option is The Little Girl's Room. Thanks so much, Lib, for the recommendation.

    ReplyDelete
  9. Sylvia: thanks. :-) It seems I was spoiled in having the same doctor for 15 years; actually, I think it was longer. My kids have had the same pediatricians for 20 years now, and my old doctor, Dr. L was part of the same practice, so it's been 20 years. The girls still see their pediatrician for certain things because she is wonderful, supportive, kind and does a lot of listening. She recently prescribed a much-needed prescription for SG2 for ADD, which was making her huge reading at college untenable. SG2 said that the doc asked her a lot of questions and really took time to listen to her and to assess the situation. One reason I think she's so effective is that she raised twin boys who are now about the age of my daughters. Lovely woman; very caring and competent. Whatever happened to GPs??? I'd go see that pediatrician in a heartbeat if she were a GP.

    ReplyDelete
  10. Dianne: that just makes me irate. Almost 900 freakin' dollars for health insurance??? That's insane. Truly insane.

    I now have my daughters both on my plan and it's costing me $318 a month. That's much better than what you had to pay, obviously but it's a huge jump for me. Even with CR's contribution, I have even less discretionary money to boost the economy with, than I did before. I may write a post about health care in massachusetts very soon.

    ReplyDelete
  11. Susan: that's a good idea. I thought of it too - since I've been examined twice by two different urologists, both of whom said the same thing: there's nothing wrong; you're not doing anything wrong, it's just the way some of our bodies are made and my has this vulnerability. I may return to the second one, if he's still around. I may need a referral, though, from Dr. R the Ice Queen. I'll have to check.

    ReplyDelete
  12. NO THING pisses me off more than a doctor who "thinks" they know more about MY body than I do...as women, we know about these stupid things our bodies do to us all too often, which is exactly why your care was left in your hands for this!! She is an idiot with power and there's nothing worse...dump her and find someone with compassion but try to make sure your complaint over her care is well-placed with people who can hear it. We can hope she is forced to change her ridiculous and archaic ways.

    And I hope for you no more UTI's, I know there is nothing worse than that awful feeling. You probably know this but do you drink cranberry juice everyday? It can really help by increasing the acid levels and killing these little nasties before they can grow up and be obnoxious.

    ReplyDelete
  13. :::::::waving at Linda::::::::

    I stood my ground and so did she, I guess. Maybe my assertiveness turned put her on the defensive. But, hey, I pay a damn lot for health care and I'm a consumer. I mean people go to their doctors all the time and ask for medications they see advertised on TV. If they weren't effective in getting doctors to prescribe, they wouldn't pay so much ad time. And I can't get the antibiotic I want which has worked me for me for a problem I'm fairly well acquainted with. I've tried everything else except what Lib suggested.

    Dear, thank you for the validation. I didn't think I was asking for morphine or medical marijuana.

    ReplyDelete
  14. Hi, with working as a Porter in our local hospital, I know just what you mean about these doctors who THINK they know ALL the answers and they let EVERYONE know that they know it too.
    Thanks for your visit and your kind comments.

    ReplyDelete
  15. Here is a link: http://www.healingtherapies.info/Urinary-Tract%20Health.htm

    and her:
    http://www.homesteadmarket.com/d-mannose.html

    it doesn't always work and when it doesn't then use antibiotics as you would anyway. I hope this helps.

    ReplyDelete
  16. Im sorry you had this experience,

    Find a new one!

    Medicine is a river which flows between the banks of carer and patient... we are here to look after our patients and if we really listen then our patients will teach us more than we can ever offer them...whilst we can recommend what we feel is appropriate given our individual training and experience, it is never appropriate not to listen to patients....The patriarchal system of medicine is archaic and should be thrown out with the rest of yesterdays garbage...

    Blessings of peace and good luck in your search for another doctor,

    There are so many wonderful ones out there, theres no need to settle ;)

    M

    Much love, M

    ReplyDelete
  17. Maithri: I wish you could be my doctor! If I had someone as kind as you to entrust my health to, I'd be happy indeed. Your patients are lucky to have you!

    I hope you have a great weekend.

    ReplyDelete
  18. I'm very glad to hear you are looking for another doctor. That is exactly what you should do. It's a royal pain to have to find someone new, but well worth the trouble. You should never put up with the Dr.R's of this world.

    ReplyDelete
  19. Can you self refer to specialist with your medical plan? A urologist would be much more qualified in this area than a GP, and they gets lots more patients with your specific medical condition.

    ReplyDelete
  20. I know that I really shouldn't post on this thread...

    ...it's just one of those things: when hearing an insured person complain about a doctor (an "annual physical"? What's that?).

    My health insurance is this:

    1) Pray I stay healthy and
    2) Failing #1, hope that the Free Clinic (stays open and) can treat whatever I've got---and that I can hang on, until their limited operating hours.

    All that said, Gina (Wot? Me bitter? ;-/), I really hope you find a better doctor. [And that you don't get another of those UTIs. Even w/ my female parts, I've never had one (involuntary celibacy has probably helped :-X): they sound terribly unpleasant!]

    ReplyDelete

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