[Giucy]

Hello,
So, after I vented about my struggles to find an orthopedic surgeon and having found one (thank God), I thought we could share our tips about how to deal with healthcare stigma.

My difficulties with doctors are linked with the fact that I suffer from ADHD and treated with ritalin.
Here, when you take ritalin, doctors treat you like if you were a sorry excuse of a patient. Once, I've been prescribed psychotherapy to cure a skin abscess (needless to say, I changed doctor asap after such behavior).
Another time, when I saw a specialist of infectious disease, I've been told by the doctor "if I was your father, I would had redone all your education without your incapable mother" first, then "I would never have let my children become a failure like you" and while he was screaming, he acted like he would be throwing things on my face. Even if this visit took place about five years ago, I am still dealing with those horrible flashbacks each time I have to meet a new doctor.

I am completely fine to answer that I take ritalin to treat ADHD. ADHD is an illness, not a sign of lacking good character.
Having a disability is not a four letter word. As much as hair and eye colors are part of my patchwork identity and don't give a clue about my being of good/bad character, so is my having ADHD by perinatal brain injury.
Therefore, I am absolutely fine when a doctor talks about ritalin for a relevant medical reason. For example, if a cardiologist finds an abnormal ECG and says "we have to check if it's because of ritalin", or a doctor wants to check about drug interactions, it's part of a doctor's duties.
OTOH, I refuse to listen anything when a doctor uses this fact to prescribe a psychotherapy even when the prescription is obviously irrelevant to the chief complaint (a pericarditis won't go away with psychotherapy for sure !).
I am not ok when a doctor dismiss whatever I say on anxiety without even doing any assessment. I am not ok being told that "seeing a psychiatrist means you always try to hide how heavy is your prescription" (heard from a GP once, never went back again).
I am not ok when a doctor plays conscience dictator instead of treating my health issues.
I am not ok when a physiotherapist say : "I could not even imagine you could understand complex concepts with brain injury" as if brain injury meant no intellectual ability, no matter what studying law at uni meant for the practitioner.

Now, I found some tips to manage the risk of being denied medical care because of ritalin. Some tips may work for you or not, so, keep what works, adapt what works so so and quit what does not work.
It may not be foolproof, but it sure lessens the risk of being mistreated by healthcare professionals !

Sure, I want a competent practitioner, knowing how to treat my health issue. But I respect myself too much to put up with being patronized, berated, medical harassment and so on just because I take ritalin and have brain injury ! I respect myself too much to put up with being a doormat patient for holier-than-thou physicians.
I respect myself too much for accepting absurd requests by bigot doctors who think that ritalin equals being a deadbeat patient unwilling to be honest about his "serious condition".
I refuse wasting my time, money and Social Security money with a doctor who refuses to treat me with basic dignity because of his personal bigotry.

1) Even when the prospective practitioner has been recommended, I take the time for a telephone interview.
I've been recommended practitioner in very good faith by people I really like, but the recommending person genuinely had no idea that ritalin would had been a big deal for the practitioner she recommended.
When I interviewed orthopedic surgeons competent on feet issues, I had a variety of answers. They were good first clues for assessing if it was a right match or not.
On the interview, I ask very matter of fact : "I've already dealt with doctors who refused to treat me because I take ritalin. How does the doctor feel about treating a patient taking ritalin ?".
Then, I assess secretary's reaction. Some secretaries didn't understand why I ask such question and reply that denial of care is not the place's politics. In such case, I thank her for the time and cross the doctor's name on my list. Such answer sweats discomfort about this ethical issue, so the place is not for me.
Another time, the secretary answered to me as if she gave a time-out to a misbehaving child. Doctor's name was crossed immediately on my list.
I also had the secretary who asked the doctor to call me back. After having talked with the doctor and had a good gut feeling, I asked practitioner's fees, some questions about what to bring, and made an appointment with her secretary.
Another time, when I had to find a dermatologist, secretary's prospective dermatologist told me that prospective dermatologist has a son who took ritalin (so, he knew what I was talking about). He ended to be my dermatologist since then

2) Sometimes, I cannot choose the doctor. This circumstances happen when I have to undergo a health assessment for administrative reasons (medical exam for driving licence, accommodations at university....).
In such a case, I prepared a template letter explaining my disability and 2-3 fundamental wishes.
Before printing the letter for the doctor, I add the doc's family name for being more personal and a few words about the reason for the visit.
Writing the reason for the visit prevented the question "so, since you have disability X, why do you come see me today ?" asked on a condescending tone. The doctor cannot say he didn't know why I was coming for, it's written right in front of him !
Since the doctor has a written letter between his hands, he understands perfectly that taking ritalin has been a fully informed choice. Then, he feels no need for a ritalin chat under the guise of health concerns.

More often than not, such ritalin chat actually turns into a grilling full of stereotypical assumptions conveyed with a condescending tone during all the visit.
Whatever your answer, you cannot win : either you confirm the assumption and reinforce doc's disrespect for you, either you refute his assumption and you're labelled "dishonest and untrustworthy patient".
Doc is too busy with his obsession he completely forgets the reason you came.

What are your tips for dealing with doctors ?


PS : Mods, I have no idea where this thread fits best.

[healingme4me]

I had no idea, the difficulties faced for those patients using Ritalin. My jaw dropped.

I really like how you enter your care, as a well informed patient. Truly sorry how much is needed to find one!

I do have one doctor, that I've a most difficult time with, over treatment, but not because of my mental health...

I'm now curious to see what others experiences are like.



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[likewater]

Just wait until you get hurt on the job. I was told by a pain management Dr that my hurt ankle (which was actually torn ligaments) was a result of my trauma from childhood sexual abuse. I actually saved hhis report. It's stupidist and most insulting thing I've ever read. How unethical and condescending to say that to me and report that to my employer just to save the insurance company some money. There is a special place in he'll for that Dr. And yes, I've run into others that don't listen to me bc I'm on antidepressants. Told a Dr I had all the symptoms of h polori. He said my diet was probably bad. Told him I was a pretty healthy water and that I was vegetarian. He countered that just because I was vegetarian didn't mean I ate healthy ( but at the time, I did). He actually said, " ok, I'll do the test, but I'm almost certain you don't have it." Guess what? I had it. And not long after, I changed Dr's office s. I have a Dr and a pa that actually listen and treat me like I have a brain.

[Giucy]

I am appalled at what you say but at the same time, I am hardly surprised.
Anyway, glad you found the right dr and the right pa It changes your health for the better !

[Giucy]

When you face bias from healthcare professionals, keep shopping until you find someone willing to treat your actual issues.
For having BTDT, I know it can be way much easier said than done.

After much searching and many disappointments, I found an orthopedic surgeon willing to treat my pain seriously and didn't fuss about ritalin.
The only moment she brought up the topic was when she wanted to check if nerve pain was a side effect. Otherwise, she treated me for the actual reason I came into her office, namely the foot pain ; not for the so-call-psychological-pain.
She tried avenues that other docs never tried, and she showed a real will to fight against pain and not against her patient.

She took account of the PTSD explaining that I won't show much when I am in unbearable pain until I am fully comfortable, but she didn't use the PTSD as an excuse to dismiss pain.

Finding the right doc was discouraging, draining, but it did worth the effort : it changed my life for the better.
It also says that to get good healthcare, we need to stop putting doctors on a pedestal as if they were above-human first, then considering the research for a doc as if we had to find a catering company for a marriage.

And even when we don't pay them, the collectivity pays for the doctor. If the doctor does not treat you with basic dignity because of his bias, your health issue will not go away by itself. Instead, it'll get worse.
So, the small issue cheap to treat will become a bigger issue with expensive complications to treat for the collectivity. Then, when an insurence company or Social Security wonder why healthcare is so expensive, part of the problem is having to put up with doctors unwilling to treat you seriously because of their personal bias.
So, next time you are blamed by an insurance company or Social Security because "patients like you are such a useless burden", you have the right to answer that doctors' refusal to treat because of bias increases healthcare costs (no matter how they react).
You have the right to refuse the blame on your person because of systemic issues.

You have the right to report denial of care because of doctor's bias. In such a case, keep evidence : keep any written element, any voicemail message, and you have the right to record sessions in the office. If the doc is unhappy, not your monkeys, not your circus.

The more you know the laws in your country, the better you can stand up against doctors.
Calling BS for what it is has nothing delusional, no matter what some doctors can tell you.
Their fear of knowledgeable patients is all about their own insecurities and incompetence.