[tealBumblebee]

I had a gyno appointment today. Completely forgot that they check your bosom and in doing so he found some scars about a week old. He said we had to talk, and we did but he went on to tell me that he documented it in my chart and put a referral in saying that I need to see a psychiatrist and that they would be calling me. This was before he found out that i'm already seeing a T. He told me that I need to see another one because T should have just "told me to stop" and that he doesn't think most T's know what they are doing and just go in the field because they are screwed up and trying to help other people with their issues.

He did say that he can take it out of my chart (i told him i dont want it there) but that he thinks he should leave it there because my gp didn't note it (he doesn't know) and he thinks he should know. He also said (after talking to me) that I would be getting a call but could ignore it if I wanted to.

Will there be some form of retaliation if I decline the referral on the basis of already seeing someone? Should I ask him to take it off my chart? What will he put instead?

[RTerroni]

Honestly I don't think they can force you to see a Psychiatrist if you don't want to

[BlessedRhiannon]

Before I started seeing my current gp and gyno, I told them both that I have significant scarring and that I'm working on my SI issues with a therapist and psychiatrist. I told them that if they were particularly concerned about a scar or wound, I would be willing to hear them out, but that I otherwise did not wish to discuss it with them. I explained that I'm being treated for the underlying issues and do not wish for their help in that area. Both fully respected my wishes and have left the subject alone.

If having mention of the scars in your chart bothers you, ask your doctor to take them out...not sure whether they'd just remove it or put in something else instead. It is not relevant to what you were seeing him for and you are already being treated by mental health professionals. There should be no retaliation if you do not accept the referral since you are already seeing someone. If you feel comfortable at least answering the call from the pdoc, you could just politely tell them that you are already seeing someone and don't require their assistance. Just ignoring the call might prompt them to try again.

It sounds like your gyno doesn't really understand SI and has a rather low opinion of therapists in general. I think I'd probably have a talk with him and explain that this is not an issue you require his help with and that you are working on it with someone who is trained to help you in this area.

[CantExplain]

I can't say I blame your gyno. He's only doing his job. Rightly or wrongly, he's trying to help you.

[HazelGirl]

Although your gyno thinks he's helping, he definitely isn't. You don't have to accept referrals to anyone, and unless you are going to kill yourself or are incapacitated, you can decline medical help.

[Favorite Jeans]

Just to play devil's advocate here: why would it be bad to see a pdoc? If you're SI'ing regularly maybe you could benefit from the additional help. This is not to say that your T is not excellent, helpful and competent but just that seeing someone with a complimentary set of expertise (in addition to her) may be of use. There is no coercion here and no retaliation if you decide against it but it might be an opportunity to get additional perspectives and support.

Gyno sharing his low opinion of T's with you is uncalled for and unprofessional. I don't see any drawback to having the info about SI in your chart but if it makes you uncomfortable, by all means, ask him to delete it.

[sailorboy]

Your gyno can't make you take his referral and his opinion of therapists is just his opinion. Don't worry.

[unaluna]

Doctors are kinda between a rock and a hard place. If they dont push enough, they dont care enough. If they push too hard, theyre being bossy. Been there. Woman up! All you have to do is take responsibility for your actions. You just tell your dr or whoever whatever you want done with your info.

[Wren_]

I think you should be able to tell him you don't want it in your chart; that you are under treatment already with your therpist and that you are already working on things with your T but it takes time

Maybe talking it over with your T as soon as possible would be good also to see what your T thinks and if they can intervene at all if needed?

Sorry that happened

Will there be some form of retaliation if I decline the referral on the basis of already seeing someone? Should I ask him to take it off my chart? What will he put instead?

Definitely get that removed from your chart. I wouldn't give Dr. OBGYN a reason, but if he asks I might say it's for personal reasons.

Otherwise, you might get physicians who blame any symptom and health condition you have on mental illness while you go undiagnosed and/or under/untreated. I'm hesitant to use the word *many*, but I know MI stigma is not uncommon with health care providers. They can be some of the worst.

It might not be a bad idea to consult with a psychiatrist. I don't know about retaliation, but I know some providers really look down on patients for not following their instructions. Maybe you could find a new OBGYN if that were to become an issue.

[monkeybrains21]

That's awful. And ppl wonder y I refuse to go to drs. If u don't want that in ur chart say so. Don't let him make u feel bad. How dare he throw another professional under the bus. I would have told him off. But to get me to a gyno I would seriously have to be drugged. I do not let anyone touch. I am repulsed by being touched by a stranger.

[tealBumblebee]

RTerroni - It's appearing that way. Hope it's true.

BlessedRhiannon - I said that I would do that for any new doctor I see. I was very honest with him about all his questions (which he thanked me for) but he was convinced that what I was doing wasn't working. He did openly admit he didn't understand s.i. and just kept repeating "you need psychiatric help".

CantExplain - Yes, I do know he is trying to help and i'm not mad at him at all. I just want to know how much power I have in the situation.

HazelGirl - He did ask if I'd been having sui thoughts and I really think that that was the only thing that kept him from taking more serious actions.

Favorite Jeans - I think the way you explained that was very elegant, so thanks for that. I've come a long way (of which he knows nothing about) but he was just like "It's been a year seeing your T - how long does it take?" I don't agree with pDocs mostly because they medicate and i'm antimeds. And I don't want it in my charts because, working in a hospital I've seen how quickly people are judged just by having any kind of mental health history.

Sailorboy - Thanks. That's my ultimate question.

Hankster - I agree with the doctors position, except more from a liability aspect than a caring aspect. I took responsibility for my actions, I was honest about what the scars came from, I told him I didn't want to see a pDoc that I had a T, I told him I didn't want it in my chart nor did I want my GP to know. The problem is - it didn't seem to convince him much because he just could not understand my position. So that's why i'm worried that something should happen if I decline the referral.

Tigergirl - I did tell him all that. He just told me that I needed to "stop doing that" and "work faster". I tried to call back and tell him (again) to take it out of my chart but they closed early. Right now I think it's best to let sleeping dogs lie with him, but I think that you're right and it may be best to shoot T an email. Thanks.

Skies - That's exactly why I want it out of my chart and never told GP! I work in an ER and see it all the time you're so right.

I don't mind the consult but I guess I just don't see how it would help me. I don't, however, want to get on bad terms with the gyno. He's actually been pretty good about letting me make my own health decisions up until this point. I was kind of surprised by his reaction honestly.

Monkeybrains21 - We've had a good doctor/patient relationship before this. But thanks. I just don't really know how to feel about it; i'm more focused on catching it before it spins out of control.

I don't mind the consult but I guess I just don't see how it would help me. I don't, however, want to get on bad terms with the gyno. He's actually been pretty good about letting me make my own health decisions up until this point. I was kind of surprised by his reaction honestly.

Have you considered lying to him? You could always say you decided to consult with a psychiatrist (outside of your healthcare system) who is a friend of a friend/family.

The stop-doing-that comment is quite troubling, not to mention the it-only-takes-one-year comment. Clearly, he is clueless about mental health issues. Might be a good OBGYN, but I wouldn't worry about taking/not taking the advice from someone so ignorant about MH...

[tealBumblebee]

Originally Posted by skies

Have you considered lying to him? You could always say you decided to consult with a psychiatrist (outside of your healthcare system) who is a friend of a friend/family.

The stop-doing-that comment is quite troubling, not to mention the it-only-takes-one-year comment. Clearly, he is clueless about mental health issues. Might be a good OBGYN, but I wouldn't worry about taking/not taking the advice from someone so ignorant about MH...

At first I didn't think I needed to - but now i'm wishing I had. I don't like relationships built on deception but we need to be able to clearly communicate as well. He said I scared him, I accepted that. I need him to accept that I was honest about everything else so I'm being honest about being okay as well. I guess I really have three choice refuse the referral, do the consult, or lie about it. Eh.

Yeah he told me a few times that I needed to stop it - not in a toddler kind of way but like a "hey you know thats not good for you - stop" kind of tone. I do agree he is a bit uneducated on the mh spectrum though... Thanks

[tinyrabbit]

He sounds ill-informed about SI. It is not helpful to tell you to "just stop" or to say your T should have - if I relapsed with SI and my T said that I would be devastated.

I think you're wise not to lie to him. You don't want lies ending up in your chart.

[Victoria'smom]

I would go to the consultant and tell them you don't want medication just a second opinion on DX and resource to get better. Not all pdocs hand out prescription first. Both pdoc I've had tried vitamins first.

Originally Posted by tealBumblebee

At first I didn't think I needed to - but now i'm wishing I had. I don't like relationships built on deception but we need to be able to clearly communicate as well. He said I scared him, I accepted that. I need him to accept that I was honest about everything else so I'm being honest about being okay as well. I guess I really have three choice refuse the referral, do the consult, or lie about it. Eh.

Yeah he told me a few times that I needed to stop it - not in a toddler kind of way but like a "hey you know thats not good for you - stop" kind of tone. I do agree he is a bit uneducated on the mh spectrum though... Thanks

Things seem a bit different knowing he was scared.

I don't build relationships on deception either, but I would not be in a relationship with a health professional who had such distorted views on mental health. I would find a new provider.

Confronting people with really distorted views has caused me harm in the past, so in some cases, I think it causes less harm to not confront extreme beliefs if you need to protect yourself in some way.

The context you add makes him sound different though. Maybe he is just being eccentric. I once had an OBGYN who laughed while he handed me a sample pack of oral contraceptives, saying my issues were "just hormones". Later I learned that risks increase substantially for women over 40 who have migraines. I was concerned about the safety of them, but he just blew it off as he casually joked about all of the hormone troubles women get when they are about 40. I had seen him for years, so i tried to trust his professional judgment. I ended up getting a blood clot. Luckily I got treatment right away, due to my own vigilance that i naturally fell back on after being exposed to his attitude. Anyway, i have that bias from my experience.

[AllyIsHopeful]

Obviously he has issues and was projecting those onto the whole population of Therapists. Many people in many careers are "screwed up", including doctors! I'm not sure if he had any business putting that on your chart or relaying the message to any other doctor you see. I think it is necessary for minors, but not adults. He sounds naive and ignorant regarding mental health because many people who self harm do not share that information in therapy. I hid it from my Therapist until it was visible by mistake. I would ask my doctor if he knew anyone with a magic wand who would make all my problems go away if he said anything like that. lol
I'm not sure if there is anyway your gyno could retaliate. Do you only see him once per year? The most that will happen is it will be in your charts and your primary doctor will be informed. I can't imagine it going beyond that. I agree with skies...maybe a new OBGYN if this does become an issue.

[Freewilled]

I'd find a new one, myself. But I don't really have a PCP that I have a long history with as I'm a bit phobic of doctors. My current doctor - I told him I'd been depressed last year (it's one of his questions for my insurance company) and he got very serious and asked me if I wanted medication. I said I had just started therapy about one month prior and he got a bit stern and said well isn't your therapist helping you?? I wanted to be like, "Dude - I just started one month ago. Chill." I said I was hopeful it would help and he looked at me again like maybe he didn't believe that and said, well if you want meds come back and see me.

Even that irked me. I'd be pissed if a doctor said anything to me about SI. I don't do that anymore but I have in the past and it's always in my mind. I would feel like saying, "stick to your scope, buddy!"

[elliemay]

Why not just accept the referral? The psychiatrist might be helpful (long shot I know, but I think it's worth it a chance to stop hurting yourself).

Self-injury is a complicated behaviour pattern and the more people you have thinking about helping you, the better I think.

Also, and I have to say this, I'm very pleased with the actions of your gynecologist. Most physicians would have ignored it as "something they just don't want to get involved in", but he didn't. He noted it, engaged the problem, and is helping to facilitate help for it. That's a big "win" in my book. I do not agree with his stance on therapists, but, well, take the best throw out the rest I guess.

Let's assume that you had an obvious skin cancer on your leg that needed treated. Skin cancer is also way out of the a gynecologist's expertise, but it's almost malpractice to not help you to get it treated, or at least say "you know what you are doing this for this doesn't seem to be helping that much, how about we try this?".

That's an engaged provider right there, worth their weight in gold. This guy is not just phoning it in.

I would be surprised if he would remove his physical findings from your examination from your chart. Like it or not, those scars and wounds are part of his medical findings and your medical history, and are documentation that he noted an apparent psychiatric problem, recommended further treatment to you, etc. His written documentation covers his butt in the case you end up seriously harming yourself somewhere down the road.

[stopdog]

Through legislation and fear we have, as a group, given mds way too much power over individuals and their own bodies - particularly women's bodies.

Originally Posted by stopdog

Through legislation and fear we have, as a group, given mds way too much power over individuals and their own bodies - particularly women's bodies.

Maybe, but any doctor who sees evidence that a patient has the potential to cause themselves harm and doesn't act AND document that fact is a fool. We can philosophize about it all we want, but we live in an extremely litigious society, so as long as the legal ramifications of non-action are there, doctors are really left with little choice. It isn't just a medical issue. We see this in education as well and I am sure pretty much every "industry" operates along the same lines. We've become a CYA society and that doesn't look to be changing.

[elliemay]

Originally Posted by stopdog

Through legislation and fear we have, as a group, given mds way too much power over individuals and their own bodies - particularly women's bodies.

Over all, I agree with you. Currently, it's very uncomfortable with all the politicians in my uterus.

However, in this instance, I will defend the actions of this provider. He saw a medical condition, engaged the problem, then acted on it, provided a referral.

It's just sound medical practice, not the result of any legislation.

Again, if this had been a skin cancer or something and the provider had done nothing, then we would likely be yelling malpractice or bemoaning how physicians just don't give a crap anymore.

I had no idea a gynecologist looked at the upper body of their patients. That sounds really fishy to me - sure, if they notice skin cancer on your leg they should point it out, but a gyn looking at the bosom... how is that even related?
That being said, I agree that since he did notice it it makes sense that he would ask about it.