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When Doctors Discriminate - article
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ddnos posted:
Good morning,

I was just reading this article found in the NY Times, Aug 10, 2013, titled, "When Doctors Discriminate," and the discrimination is against those with mental illness(es)

I can ALMOST excuse the general public from discrimination/stigma toward those with mental illness (I said, "almost") but I guess I expect more from the medical community! Our doctors really NEED to be educated and need to STOP treating their mentally ill patients like second class citizens!

If interested, read this fairly short article on the topic:
http://www.nytimes.com/2013/08/11/opinion/sunday/when-doctors-discriminate.html?_r=2&

Debbie
Forgiveness is letting go of the hope that the past could have been any different --Unknown
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mercygive responded:
Something similar happens to me at my pcp office. Since my pcp has cut back his hours I make appointments with his PA. The PA has worked there about 3 years and quickly reviews my medical history which is about 14 years long. The screen displays my recent medical history and a list of all the psychotropic medications that are prescribed by my psychiatrist. The list of these medications must be bolded in big print red because the invoices I received from my last two pcp office visits indicate that I was 'treated for anxiety.'


The problem is the PA did not treat me for anxiety at either visit. One, I was treated for back pain and I suppose I appeared anxious because I was in so much pain that I could not stand up. Two, I am required to schedule an office visit each time I do lab work to renew my thyroid prescription. Unless there has been a major change in my all around physical health, a once-a-year physical exam office visit should be enough to accommodate bi-annual lab work to measure thyroid levels. The required additional office visit is a rip off and I express my opinion at every appointment, calmly.


If I schedule a doctor appointment to be treated for something other than anxiety, how can the PA indicate that I was treated for anxiety when I wasn't? I am concerned that incorrect diagnoses are encrypted permanently on my health records. I will take my invoices to my next pcp appointment and ask the PA, calmly, to update my health records to reflect my true medical history. Can history be undone? We'll see.
A little yoga goes a long way
 
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Anneinside replied to mercygive's response:
Having you come in for a med check for your thyroid more than once a year is not unreasonable. My pdoc has my blood sugar and cholesterol checked every six months and the report is also sent to my PCP as he is the one that prescribes my cholesterol medication. He only writes a script for six months at a time even though my test results have been good for several years. I want my tests to be up to date so that any problem can be caught relatively quickly. One year is not often enough. He does write a script that covers a year for my nose spray and rescue inhaler but there are no tests that need to be done.
 
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melly2210 replied to mercygive's response:
Heyas Mercy!

I've done a lot of research recently into the thyroid testing and illnesses (they THINK my blindness is coming from various mytochondrial or thyroid issues). Anyways, my research was telling me that the thyroid testing can be different even hour to hour and depending on the extend and type of condition that more frequent testing may be required. So MAYBE that's what is happening in your case. I would ask if the there has been fluctuating levels in your hormones that may indicate more frequent testing. Ask specifically what the lab orders are requesting and don't accept the generalized response of "your thyroid." I also double check what is being checked when the blood is drawn at the lab. They tend to be way more upfront about the testing. If I don't already know the terms they use, I ask what it indicates.

Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all. ~Emily Dickinson
 
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melly2210 responded:
I can relate to this article in so many ways. My blindness was an ER trip with stroke symptoms which have progressively gotten worse. ALL of the symptoms were written off as conversion disorder (aka la belle indifference). Supposedly my body manufactured the symptoms I was exhibiting because of an outside trigger. At that time, there was no negative triggers happening. I was stable, happy and even laughing and joking around when my vision suddenly changed.

My PCP read the hospital workup report (simply the summaries of the neuro, pdoc and pcp) and stopped dead at the conversion disorder and sent me on my way telling me my vision issues would go away in time. On to a neuro and opthalmologist. Neuro turned out to be a neuro-psychiatrist (they didn't bother to tell me that with the referral) and after an extensive exam and tests which included a lumbar puncture, he informed my that my vision changes were indeed "definately real" and the stroke symptoms were likely conversion disorder FROM the sudden vision change. The opthalmologist (and neuro-opthomologist) confirm that my vision has qualified me as "legally blind." I am designated as "low vision" with no dx as of yet.

Flash forward seven months.Yes 7 MONTHS. I see a optometrist who specializes in low vision and is linked directly to the Lighthouse for the Blind. No one has ever done a contrasted MRI which would reflect smaller areas that are changed that is impacting my vision. No one has ordered a Visual Evoked Perception test which measures brain activity (like an EEG) while I stare at a screen of varying changing patterns and lights. And if those show no indicative results, then I move on to testing for mytochondrial diseases.

Preparing for that possibility I visited my PCP for a regular 3 month check up. I am walking with a cane, wearing dark glasses to shield me from the lights, and eye exhaustion from trying to read the paperwork to verify any changes to general info (it was all in a 10 pt font and couldn't provide me with a large print option. I asked if someone could read and fill it out for me and was told there wasn't enough office staff to do that.). He asked about the status of my eye exams and dx and when told the updates he already had in my file. I also said that they were leaning towards mytochondrial diseases and why. I asked to have blood work drawn to begin identifying these possibilities and was told a specialist needs to run those tests. He was also trying to reject the contrasted MRI because I've had 4 other specialized MRI's.

In checking out, I got the referral for the MRI after threatening to contact my case manager with my insurance company and was told they had no idea what a VEP was and they would need to research it. A week later, I called to check on the VEP referral because the optometrist wants the results so we can move forward. No progress. So I Googled it. Called the insurance company to see if it would be covered and checked to see if the dr's I located locally were covered. Found out the exact process the pcp needs to do because the dr's weren't covered and then called pcp to explain the details. All of which I found out in about 10 minutes.

Same on a recent ER visit. Severe adominal and chest pain. Blood work. Urine analysis. No pain meds, not even NSAID or tylenol. Sent home with a prevacid script. I spiked a fever 2 hrs later of 104.8. PCP follow up. I had pneumonia and that they prescribed an antibiotic. I will be switching PCP's and will NOT return to the ER/hospital I went to for both incidences. All because I am bp.

Results? Blindness that progressively worsens because very few see past the bp dx except for a generalized optometrist who in most cases sees gen eye disorders and writes scripts for glasses. If it turns out that the contrast MRI reflects something or mytochondial disorder that an earlier dx could have halted the progression of my blindness, I am not sure what I am going to do. Maybe legal action.

Hope is that thing with feathers that perches in the soul and sings the tune without the words and never stops... at all. ~Emily Dickinson
 
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mercygive replied to melly2210's response:
Yikes Melly!
I have never heard of thyroid issues in connection with blindness. I think I have read that people with bipolar have thyroid issues, but maybe that is just relative to those who take lithium. Like my post to Anne, I think I have taken my thyroid health for granted. The biannual tests have become routine for me. I would like to read the articles you find about thyroid and blindness.
A little yoga goes a long way
 
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mercygive replied to Anneinside's response:
Hi Anne,

I was diagnosed with hypo-thyroid 17 years ago and my medication has been adjusted three times. Perhaps I have taken my thyroid health for granted. I don't mind an office visit for an annual physical. I don't mind the biannual blood testing to renew my scripts. It's just that doctors cannot physically look at me and know anything about my TSH, T3, T4, cholesterol, blood sugar, lipids and whatever else they look for in a blood test to measure thyroid levels. My thinking, maybe the cart before the horse, if the blood tests come back and show any cause for alarm then I wouldn't mind scheduling additional office visits.
I think it might be worth my time to read through articles that would help me to better understand hypothyroidism and ask questions during my office visits.
A little yoga goes a long way


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