Thursday, February 28, 2013

Doctor Shopping...

Haven't blogged in a few days, not because I have nothing to blog about, quite the contrary, I have too many things to blog about and can't choose which to do first, so expect a couple of blog posts today...

This one is about doctor shopping. You've heard the term; it is loosely connected with people who go from doctor to doctor to gain multiple prescriptions - usually to abuse themselves or to sell as a money spinner.

Another way I have heard this term used is with regard to seeking the care of one doctor after another until you get the care you are looking for - often in relation to seeking a particular kind of diagnosis or answer to a question.

Sometimes it is just a matter of getting a second opinion when the first opinion doesn't ring true. Sometimes though it's about getting a fourth, or twentieth opinion. Usually, a lot of doctor shopping reflects poorly on the patient because they are viewed as refusing to accept what several doctors have told them. It s a bit like the flies on horse shit saying, you know the one, 'One million flies can't be wrong, eat horse shit!'

Just recently though, I have been encouraged to doctor shop by friends who have experienced ongoing frustrations with doctors who refuse to really look at what is going on with the patient - often times the patient is someone's child.

There is always a lot of media about 'over diagnosing' certain ailments. In the 90s the over diagnosed ailment was 'Chronic Fatigue' - many doctors simply refused to even accept such an ailment existed, after all, it was only diagnosed in the absence of anything else being the cause of symptoms.

ADHD is another illness which is often accused of over diagnosis, and most recently Autism Spectrum Disorders have been highlighted as over diagnosed.

Quite possibly these ailments are over diagnosed. Quite possibly they're just so high in the consciousness of teachers and doctors and other professionals that other causes of symptoms fall into shadow.

However, I have discovered that there seems to be a practice of undermining proper evaluations of symptoms among certain kinds of professionals who label themselves 'specialists' in a disorder, only to reveal later that they do not actually believe the disorder exists. This has happened to us twice now. We are seeking an evaluation of ADHD for Erik. We sought such an evaluation when he was eight and encountered a somewhat hostile practioner who did not believe that Erik or any other child had ADHD. She was nonetheless given the role of evaluating children for ADHD - presumably none of her patients were ever diagnosed with this disorder.

Translate: ADHD is code for poor parenting choices.

That doctor's evaluation of Erik was that while he was moderately inattentive, she felt this was a result of only having been at school for a year - i.e. he started two years late because we were homeschooling him - and that his symptoms would most likely subside with more schooling. In other words, we had not afforded him the benefit of early institutionalisation and therefore he was maturing later than other children...

Again, we have just recently started the evaluation process again. This time I was very careful to seek a psychiatrist who - according to the Royal Australian and New Zealand College of Psychiatrists site - specialises in childhood ADHD. Only, it turns out he doesn't believe in ADHD either.


I would be happy enough to hear that Erik does not have ADHD, but I want to hear it from someone who actually does believe this disorder exists and isn't simply ruling him out as a candidate because they don't believe in the existence of a disorder. That's a bit like saying, 'No, Ms Dal, you son doesn't have sunburn because there is no such thing as a sun.'

I can see how parents are forced to doctor shop. Forced to keep looking until they can find a practioner who will take their concerns seriously and not simply throw them in the 'over anxious, possibly Munchausen by proxy' basket.

As it also turns out the RANZCP had it incorrect that this psychiatrist bulk bills, and yet, the psychiatrist wants to ring me back on Monday after he's 'had a think' about whether or not he wants to take Erik on. I did say to him we cannot afford to pay, and he did say he does not bulk bill, so I'm not entirely sure what he is having a think about. I need to find some way to say to him that I don't think he will fit our needs are he doesn't even believe in a disorder both my mother and I have been diagnosed with.

Oh, and don't get me started on trying to get a diagnosis for a child if you are on a very low income. It's basically impossible unless your child is destroying the joint... More on that in my next blog post...

No comments:

Good Job!