Doctors, they exist in our daily life. From your family GP to specialists to someone you know who is one. They all have degrees, most of the time several in fact. But qualifications are not the topic of today. What I want to talk about is, what makes a doctor beyond his or hers qualification?
In my country, we do not need to contact a specific family doctor for appointment if we fall sick. On the contrary, when that happens, we just need to drive to the nearest or preferred physician – in hospitals or clinics, and wait for our turn to see the doctor. Thus, I have had the privilege of meeting quite a number of them and seen the many faces of doctors.
What prompt me to write this is a recent encounter with one who has or rather, lack some qualities which I deemed should be on the job description of one. I understand most doctors are very busy individuals and specialists working as surgeons often work in high stress environment. So, I’m not here to do nick picking.
Pediatricians are usually the most friendly bunch of doctors that you will meet. They work with children and they are not stingy with smiles or treats. GPs or your general family doctors are more of a mixed bunch. There are the cranky ones, the I-don’t-really-know-what-I’m-doing-please-refer-to-a-specialist ones, the MedPoppers and the ones that you reaaaaally love. Who makes the visits a meeting with an old friend rather than an inspection.
Growing up, I am pretty lucky, and have seen many friendly and compassionate GPs. They always make me feel safe and are attentive in their check ups. Never prescribe unnecessarily and never intimidate me during the visits. They also have a neat trick of having a handy jar of rarely found candies – ranging from jellybeans to sweets – which as a child, I would look forward to having because I just can’t seem to find them in shops!
On the other hand, I have also experienced a number of doctors who make me feel like they are rushing me out of the room and that I am wasting their time. Hey, I am the one paying the fees here! Some specialists that are never sure what they are doing and give vague answers and just a few days ago – a particularly blunt one who really need to work on his communication skills and work ethics (I am trying to think of it as that and not negatively of him instead).
So, this fellow Dr. C is a psychiatrist whom I was planning on consulting long-term, but not anymore, for my depression. Since I wanted some “more professional” insight into my condition other than the therapist that I am seeing. My therapist is great, but I just wanted to make sure that I am not off the deep end and get my situation assessed by a doctor.
After a journey of 2 hour, I arrived early for the appointment but was admitted about 15mins late. “Busy schedule probably,” I thought. On the plus side, the doctor did not beat around the bush and got straight to the point. I told him my general situation and then, he asked me a series of questions to assess my situation – which I know the intention being an ex-medic student myself.
He picked on the part when I said I did not resume attending medical school after my operation and tried to make it out as me being afraid and stress of returning instead of what I insisted as, which is I am worried about working in the field as a doctor in the future with my vision ability. He never once asked how serious my vision problem is and how it affects me. Just the operation that I did, and why didn’t I return. And then proceed to make it sound like I am the one refusing to return because I cannot handle the stress. Sure I am not returning but it’s because I already have problems seeing demonstrations made by my lecturers clearly, of course I am worried!
Then, we talked about my personality. My parent, the one who went with me said something about me having a rough time prior with classmates in high school and he started again to pin it on my personality. To quote him, he said, “It’s not people’s fault, it’s all your personality’s problem.” Um dude, I didn’t even say it’s others’ fault. No, it’s “not“ their fault if they are the one getting out of their way to do those things. On top of that, I did not even mention that I blamed anyone for it. Of course it’s my personality problem. I am awful. Wait, is a doctor supposed to tell your patient that and make them feel like they are bad people when they are trying to seek help?! And if they don’t have a problem, why would they be in front of you?!
What my therapist said was, “Every personality type has its flaws and strengths. We should embrace our personality, celebrate the strengths and try to change our flaws.” What they both said is essentially the same thing. But also two very different things. One told me that I am awful for being a perfectionist. It’s how I ended up like this, I should blame myself and hate myself because I am the only one at fault here. The other told me that my personality has its pros and cons, and everyone has personalities albeit varied ones. And that I should not dislike myself because of my personality but instead work on making myself into a better person.
I mean, if I blame others for things, maybe I will not have felt so bad for not continuing my studies as a medic student. I am basically blaming myself for my inability to continue. So, the doctor decided I am externalizing my blame and should blame myself more. Wow, go figures.
Next, he moved on to the questions. Very specific ones that make me, who is aware of which of these questions are linked to what mental diseases, felt like he was picking off a checklist and a vague answer would put a tick in his checkbox. These questions while I know to answer clearly, many with less awareness on these topics might not have. For example, on OCD – “Do you clean your hands often?”, “Do you like cleanliness?”. I think people who doesn’t understand his questions might have said yes and get labelled. “Do you self-harm?” (I tried looking at him blankly first for this one and he did not bother to explain what counts as self-harm either) and many more.
Afterwards, he talked privately with me for around 10 mins where he asked some other questions which I was not feeling comfortable answering in front of a parent despite having voting rights. Additionally, he showed me a video of a doctor who continued to help others in her hometown while utilizing the use of prosthetic legs. I think he was attempting to encourage me and he said some reassuring words which goes along the lines of, “There are many more people living in worse condition than you. You should not feel that your situation is bad and be unhappy about it. You have a loving family and arms and legs. Go live bravely.”
While his intention might be well-meaning, he made me feel as if he thought I viewed my situation as a miserable one and I am ungrateful (He never asked how I felt about my situation). He was also comparing a person’s problem with another’s. That is against my principle. Sure, that person might be more fortunate than many others, but telling someone this makes their problem invalid is just appalling. Everyone has their own problems and they need to deal with them themselves while you deal with yours. You cannot and should not compare someone’s problem with another’s, nor tell them their problems are unfounded.
The last straw for me was when I said I do not want to take medication because I am worried about the side-effects, he told me that I should go google the side-effects of Panadol (Paracetamol), and he cannot treat someone who does not want medication. He also said I could try therapy which don’t really work (His words, not mine!) and if I change my mind I can come back to make an appointment. That was the worst possible way to handle the situation for a practitioner. Wake up call, docs: Gone are the days where patients meekly accept diagnosis and prescriptions. Most patients today are moderately informed and painfully aware of their rights to ask questions.
Comparing medicine like antidepressants to over-the-counter (OTC) stuff like paracetamol is just laughable. The median lethal dose itself is a proof of this ridiculousness. Plus, I did not googled them, I studied them remember? First off, decreased sex drive, weigh gain and insonmia/drowsiness are included in the common side effects of SSRIs antidepressants, which are regularly prescribed. Bear in mind I am a student so the insonmia/drowsiness part would be very undesirable, so is the weight gain. I love my weight and I feel very comfortable, I do not think making me overweight would increase my mood. Moreover, they have serious withdrawal symptoms if you stop them suddenly. While there are no meds which does not have side effects, the ones that antidepressants have are much more serious. Is it so wrong that I am concerned?
When a patient say they are refusing to take medication because they are concerned about the side-effects, the doctor should explain the side-effects and reassure them if it’s not as bad as the patient assumed. Even when prescribing medication to patients, physicians should always inform them of possible common and noticeable side-effects without waiting for them to ask. And when they do ask, you are the doctor! If they know the meds, they won’t be seeking you out. So it is your job to answer their questions, not shoo them off. Another thing, therapy is not useless. Saying therapy is useless and a patient should only seek medication as their only treatment option is wrong and misleading. There are no magical pills, but they are no one way roads either.
After a 20 mins consultation – for a psychiatrist and for new patient this is certainly not the presumed allotted time. I was expecting something similar in length to my therapy sessions. More so because he told me to reschedule my appointment to a weekday instead of a weekend, because weekdays are better for new cases. Does not seem much of a difference now, does it?
All in all, I am not losing faith in psychiatrists and I am glad that my situation is less dire than initially assumed. It’s a shame that someone working in such a field should have such attitude. I expected a much more in depth attempt at understanding the patient as a psychiatrist from him. This is no eye check ups where only facts are needed and he is not a busy surgeon. So, no hurrying a patient out is needed. In fact for his specialization, it’s probably a bad idea for a new patient. Even as a regular doctor, his working ethics are poor.
Closing off this rant, I think doctors should at the very least make you feel at ease, which I never for once felt with this one. And if possible, have a compassionate heart. They might be busy individuals but it does not hurt to try. Patients come to you to seek help, not to get mistreated or to burn off some spare cash. I went in with hope and came out feeling more depressed than I have felt in the entire week. I think, even if this doctor is very qualified and pro at his art of treatment with medication, I would not want him as my doctor. He might be a good doctor, but not a suitable one for me.
It’s counter productive to get treatment for depression from someone who makes you feel worse after every visit. Don’t you think so?