In the September issue of “Women’s Health Magazine”, there appears a feature titled “The Doctor Will Judge You Now”. (1) It included stories of four women who related how they were shamed by their doctors while seeking medical care about sensitive topics. One story relates how a transgender women felt shamed when her doctor asked her if she had a PAP smear, and couldn’t understand why she didn’t need one. Another was shamed for being overweight and yet another for having multiple sex partners. The final story was an African-American woman who failed to be properly diagnosed and instead labeled a drug-seeker because, as she believes, her race.
On reading these articles, I agree that these women were not treated appropriately. Their doctors failed to provide adequate care. But, I also feel that it is wrong to be so judgmental of all doctors based on these sad stories of a handful of patients. The truth is that the vast majority of us doctors do care about our patients and try to give them the best care possible.
I feel bad that these women felt shamed by the system when they turned to a trusted physician for medical help. Let’s be real, though. There are bad apples in every group, even doctors.
I always tell my patients that they should never be treated by a doctor they do not feel comfortable with, even if that doctor is me. Doctors are human and we have our own personality quirks. Sometimes personalities just clash.
As a doctor, I know my patients trust me to give them the best medical care that I can. In medical school and residency training, it was stressed upon us to not cast judgment on our patients. We need to treat them all the same. I have had the privilege to treat patients who were homeless, some who live in mansions, others who were great leaders in the community, and a few who were transferred from prison just for medical care in my practice. Every one of them received my best without judgment. Most doctors are the same way.
There are often uncomfortable questions that a doctor needs to ask patients in order for them to receive the best care. Questions do not necessarily mean judgment.
For example, a woman who has multiple sex partners is at risk for a whole host of diseases including HIV, hepatitis, Chlamydia, gonorrhea and others so it is reasonable to ask her about her sexual activity. I do not know if she is at risk unless I ask. Sometimes we need to tell patients what they don’t like to hear – not to shame them but to treat them. For instance, a patient who is having knee pain would do better if they lost weight if they are overweight. But they may be sensitive about their weight and not want to hear that…
The important thing is making sure these conversations are conducted in the right way. Doctors need to realize the sensitivity of these issues and keep judgments out of the exam room. We need to treat all our patients the same, as human beings in need of help, regardless of who they are, what they look like, or their background. Anything less is unacceptable.
I feel particularly bad for the patient who discussed shaming because of race. She should not be labeled a drug-seeker without benefit of previous records or diagnostic studies. Physicians often find themselves in a tricky spot, as we are facing a huge epidemic of prescription drug abuse and more and more people are dying because of it. I see young teens in my practice that are addicted to IV heroin. These children started off abusing pain killers. As doctors, we must balance the need to keep our eyes open in an effort to end this epidemic. However, this should not come at the cost of innocent patients like the one who related her story in the article. I also want to stress that even if a patient were a drug seeker, they still need our help. They did not get addicted to pain medications on their own and would benefit from a treatment program.
While this series of articles tries to show how doctors are overly judgmental, I find it highly ironic that the article turns around and judges all doctors in a bad light. Patients should not be pre-judged and neither should doctors. Articles like this only serve to drive a wedge in the doctor-patient relationship. Yes, we need to hear these stories and realize there are bad doctors out there as we strive to #StoptheShame, but please present this in an unbiased light. Do we ever hear anything about the good doctors who go above and beyond for their patients, every day? Those physicians who spend hours after work updating charts, fighting with insurance companies until necessary tests are approved or working a worried mother and baby into their already packed schedule? It’s disheartening to see a series of articles that could be so powerful stoop to the level of the physicians they’re exposing.
Articles like this only serve to raise fear among patients and are (dare I say) dangerous, as they may discourage others from seeking medical care when it is truly needed. A responsible article would have also given women tools to avoid and deal with medical shaming and show them how to search out doctors whom they can trust.
Isn’t it time we were all more responsible?
Dr. Linda Girgis MD, FAAFP is a family physician in South River, New Jersey. She has been in private practice since 2001. She holds board certification from the American Board of Family Medicine and is affiliated with St. Peter’s University Hospital and Raritan Bay Hospital. She teaches medical students and residents from Drexel University and other institutions. Dr. Girgis earned her medical degree from St. George’s University School of Medicine. She completed her internship and residency at Sacred Heart Hospital, through Temple University where she was recognized as intern of the year. She is a blogger for Physician’s Weekly and MedicalPractice Insider as well as a guest columnist for Medcity News and HIT Outcomes. She has had articles published in several other media outlets. She has authored the books, “Inside Our Broken Healthcare System” and “The War on Doctors”. She has been interviewed in US News and on NBC Nightly News.