Quote:
Originally Posted by lucydog
I think I'm a little sensitive about this subject because it comes up so often for me professionally.
I would never stop seeing a diabetic the first time they took their insulin wrong. I am going to meet with her (literally) every day if necessary until she gets her blood sugar under control. I am going to try a dozen different medications until we find one that she can tolerate. I am going to print off handouts from websites and discuss weight loss and draw pictures on a white board. But, after a few years of this- including multiple trips to the ER- I'm going to decide that I am just not the right provider for this patient. I'm going to recommend that she see someone else. It is clear that she and I just cannot communicate. I don't speak her language.
Substitue "asthma", or "heart disease" or "depression" for diabetes and this is my daily patient load.
Am I a bully for firing 2 or 3 patients in my 10 year career as a medical provider? Perhaps. But I just hope that their next doc was able to speak their language and reach them.
Finally, I look at myself. My own doctor has written me for pscyh meds and I choose not to take them. I just can't bring myself to. I am the master of my own fate, I am allowed to make my own choices. But, the day he has to visit me in the hospital is the day he gets to insist I start taking that med.
I bet this isn't very interesting to most people, but like I said it is very important to me. Thanks for listening to me rant.
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You sound like a very caring health care provider Lucy. I think diabetes is a great comparison because it also takes a lot of emotional support for a lot of people, since it needs so many behavioral adjustments. I imagine a therapists support could be very helpful for making and keeping those adjustments. I don't know if therapy is commonly recommended or available or taken advantage of, though I know there are some therapists who focus on medical issues. I guess that there would be a lot of crossover between being a medical provider and being a psychological provider with diabetes too. It sounds like you're really aware of the support needs and it's great you're able to spend a good amount of time with patients. i know of some diabetics who got none of that though. I suppose there are issues with some health care providers who are too emotionally detached to know how to help, or even to want to help, as well as issues with insurance that doesn't cover the time needed.
I also agree with you about refering patients on in the situation you described Lucy. I think that's a lot better than a lot of health care providers who just give up and let the patient keep getting worse.