Posted by fachad on July 20, 2002, at 3:27:47
In reply to frustration - the medical monopoly, posted by Elizabeth on July 20, 2002, at 2:24:11
Of course you knew I couldn't possibly leave this one alone. I doubt if I'll even be able to keep myself to just one post...
When my previous pdoc closed his practice, I made one last appointment with him to go over a list of pdocs on my insurance plan.
I remember him giving descriptions of each doc, their styles, etc. Of the doc I am now seeing, he said, "he doesn't do much in the way of psychotherapy. He's strictly a psychopharmacologist."
Then I remember saying, "Oh, that's fine. I can do cognitive therapy on my own, I can read Jung and other depth psychology things by my self, I can use reason and insight to make my life better, all I need a pdoc for is to write for meds."
I later felt bad about saying that, because in a way it put down the wonderful insight based psychotherapy that that he did in the 15 minute med check appointments he was forced into.
We might talk about nothing but neurotransmitter receptor affinities, and second messenger systems, but I always ended up laughing my ass off and I always left his office feeling better about myself. He was a truly amazing physician in the classical sense of the word, and a true healer of the soul.
But back to your frustration. I saw it as clear as day back then - the only reason I see a pdoc at all, ultimately, is to get prescriptions.
Like you, I have come far enough along that I have no use for diagnostic cubbyholes, or treatment algorithms, or any sort of moralizing. I don't want to be subjected to first line treatments again. All I need is my scripts filled. And the only way to get that done is by an M.D.
As you said, "this impinges on a very basic freedom of mine, the right of self-determination." It assumes we are stupid and must be protected from ourselves. It's a very unfortunate consequence of a parental, authoritarian government reflected in a parental, authoritarian medical system.
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> Hi everyone. I've been struggling onward, working with a new pdoc who is, shall we say, less open-minded than the ones I'm used to. (I posted about this a while back.) It seems to be working out okay, but I'm left feeling frustrated that I have to be dependent on a doctor to get the medication I need. You know?
>
> I'm pretty sure that I know more than my doctor does about my own psychiatric history, present symptoms, and response to medications. I'm also pretty sure that I understand at least as well as she does how the medications I take work, on the molecular level and otherwise. She does have important knowledge of things like pharmacokinetic interactions which I might miss, but it just doesn't seem right that it should ultimately be her decision whether to permit me to take a particular remedy. It seems to me that this impinges on a very basic freedom of mine, the right of self-determination.
>
> At one time I was faced with a doctor who refused to prescribe the medication that -- according to records to which he had access -- would help me. As far as I could tell, he would rather see me continue to be depressed than take a "bad" drug, and I narrowly escaped being committed by this bastard (refusing to treat me, to the end). To this guy, the thought of prescribing Buprenex for depression -- even on a trial basis -- was so repulsive that he would rather cause a depressed person's suffering to continue (although, to tell you the truth, I didn't get the impression that my well-being was a very high priority for him). And I didn't have the option of saying no to him. His opinion was law. It was a terrifying experience, and even now, months after, I'm disturbed just thinking about it. *shudder*
>
> We all know that doctors sometimes appeal to morality -- their own subjective morality -- in making medical decisions. I just wish that my ability to be well didn't depend on whether I can find a doctor whose morals don't make him/her too rigid to prescribe the medication that works for me. It seems like most doctors in average American cities are pretty rigid, alas.
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> Anyone else having similar thoughts and feelings?
>
> -elizabeth
poster:fachad
thread:112998
URL: http://www.dr-bob.org/babble/20020718/msgs/113000.html