Mental Health and discrimination
 

an interesting article about doctors discriminating against people suffering from mental illness

http://www.nytimes.com/2013/08/11/op...anted=all&_r=0

I wonder why?

Why waste my time?
This could get real complicated and time consuming?
I don't want to risk a lawsuit?
My malpractice Insurance is already too high?
Company policy?

I would suspect the second, but my level of knowledgeis on a par with a cube of jello. My shrink friend posted it on facebook and I was drawn by the title.

When a crazy guy walls in to the ER, the doctor sees crazy first and patient second. I have had several patients die because they were known as frequent flyers and actually were having heart attacks, stomach cancer, appendicitis, and seizures, to name a few.

BUT the author of the article doesn't have visible crazy -they started discriminating once they were told of the mental illness (bi-polar).

We're all a little weird here in the cellar and some of us have mental illness, but are we really "crazies"?

Is all mental illness "crazy"? Maybe you're one of them?

Because unlike physical disabilities, there is a tendency to believe that a person's behavior--no matter how clearly linked to a chemical imbalance or neuronal pattern difference--is still fundamentally their choice, their fault.

It's not about blaming the victim though, it's about the observer feeling powerless: if that mentally ill person is not ultimately responsible for their behavior on some level, then the sane person also cannot take credit for their mental stability. If we're just bags of chemicals and it's all a crapshoot, then you don't get to feel good about anything you've accomplished in your life. Blaming the mentally ill is just a logical continuation of a human being's basic ego.

Well, anyone different than me is obviously flawed, so if they don't limp I have to assume they're crazy.

Oh wait... maybe I'm crazy and they're not... or we're both nuts... but I limp a lot... hmm... nevermind. :o

perhaps it's your nuts causing the limp?

in either sense of the word


But seriously, this is alarming, isn't it? That members of the medical profession who ought to know better allow their illogical prejudices to affect their treatment of a patient in such a serious way

They're a little smarter maybe, better educated for sure, larger egos from what I've seen, but still human, with all the warts and flaws, not gods.

It's a high pressure job and if they suspect someone of making it tougher, I wouldn't be surprised to see them go into defense mode.

I'm not so sure, Bruce. I think most of us say "My God!" every time we see the doctor bill. So...:neutral:

Yebbut..... how is someone with bi-polar whose mental condition isn't noticeable until drug info is shared making a doctor's life harder? I agree if it's someone demanding drugs for a complaint that hard to verify......

Possibly because the doctor doubts the diagnostic assessment that lead to the prescription in the first place... As one example, I take an anti-seizure med that has been, in recent years, rampantly prescribed off-label for depression. The last two times I went to the hospital, there were multiple times where I would give my current medications and various assistants or doctors would say, "...for depression?" When I said, "No, for partial temporal lobe seizures," they would look surprised.

Meanwhile, many years ago when I was first trying to get the seizures diagnosed, I had a doctor tell me they were just run-of-the-mill panic attacks and try to brush me off with a quick prescription for Xanax. I told him I wasn't going to take it because I knew that's not what was going on, and he made me take the paper anyway, "because you might change your mind." Psych meds are so common now that many doctors assume they've been wrongly over-prescribed until proven otherwise. Scorn is a doctor's natural demeanor.

If they are legitimately bi-polar and taking drugs for it, there's a good chance it will make the treatment of anything else more complicated.

:facepalm: I suppose I'll die with a scornful look on my face, then.

Yes, bipolar meds make things more complicated. However, it's been my experience, having raised children with mental health disorders, that nurses are more prone to labeling and stigmatizing.

I have many nurse friends/acquaintances, but away from their work (which is where I see them) most of them strike me as the people least likely to become nurses. maybe they save all their empathy for the patients. The one I know best certainly says some horrible things about the families of her patients, much of them stereotyping/labeling-type comments that make me very uncomfortable. But she deals with children with cancer and I suspect it's a mechanism to stop her "caring too much". But I think I might be more concerned if she were deciding the course of treatment.

Doctors rely heavily on interpersonal communication, especially during the initial workup on a patient. The most important part of the physical examination is the patient History. If anyone ever asks "What are the three most important parts of the physical examination?", the answer is History, History, History ... like Location, Location, Location in real estate it's that important. Anything that interferes with the doctor being able to get information, especially reliable information (not erroneous information or even disinformation), from a patient is an unwelcome game changer for the doctor who bases treatment plans on that information. The doctor's oath to "First do no harm" can become a longshot with serious consequences all around if even unintentional harm is done.

Present company excepted, of course. ;) It's not always directed at the patients--I've found more often than not the doctors are being scornful towards each other behind their backs. I can't even count the number of times a doctor has looked at a previous doctor's orders/diagnosis/etc. and expressed bafflement or open disapproval at the decisions made. Very few of them will acknowledge how much guesswork they're all doing; it's always the other guy who's an idiot.

It helps to give people insight into the fundamental difference between the way doctors and nurses think. A nurse deals mostly with the science of medicine. Every time a nurse learns something new, a nurse thinks that's one less thing they don't know and that they're one step closer to being the consummate nurse. A ramification of that is they can believe they know best how to categorize and deal with patients. A doctor deals with the science of medicine and additionally with the art of medicine to a greater degree than nurses. When a doctor learns something new, it opens the doctor's mind to two new questions the doctor hadn't considered before. Doctors are humbled by that experience despite their significant accomplishment in becoming doctors and it tempers their egos enough that they are less likely to develop tunnel vision regarding their patients. This difference between doctors and nurses is why the idea of nurses going to medical school has not been enthusiastically received. Nurses not only have to learn new things, they have to learn a new way to think.

Bull...

...Shit.



This might be one of the funniest things you've ever written, sexobon.

Ignorance is bliss, you haven't WORKED with enough doctors AND nurses newbie.

It's very cute how you take the thing I was saying ('doctors are not open to new ideas') and act as if it had anything to do with what you were saying ('doctors think better than nurses.') Shit, for all I know nurses ARE even worse than doctors in that area. Not what I was talking about.

Cute is as cute does.

If you had cut the quote off here:

I would have got this:

This,

... WAS contrasting doctors and nurses (i.e ... they are less likely [than nurses] to develop ...). I took your response to be addressing both.

Sorry I couldn't read your mind. Well, actually I can; but, then I'd have to bill you!

Seconded, big time. :thumb:

I'll use this thread to introduce a somewhat different current topic... Obamacare and mental health.

There is an "experiment" going on in North Carolina that is being watched by many...
Today, the NY Times has an article that serves to introduce one of the new ideas to the public.

http://www.nytimes.com/2013/12/26/he...it_th_20131226

NY Times
JULIE CRESWELL
December 25, 2013
E.R. Costs for Mentally Ill Soar, and Hospitals Seek Better Way
The importance here is that most laws, rules, and traditions,
have been to require transportation to hospital ER's only.
Obamacare may be the mechanism to change the system
into something more efficient and appropriate to the individual patient.

I skirt the issue by referring to my anti=depressants as "performance enhancing drugs" Much less stigma attached to those.

:D

I might be wrong, I frequently am, but, I don't think the word 'efficient' will ever be associated with ObamaCare.

"Some have noted that ObamaCare is an efficient time waster."

Just spitballin' some ideas around.