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Patient fired by her doctor

CARLY WEEKS

From Friday's Globe and Mail

Latest comment posted at 2:00 PM EDT 29/02/08

Physician terminates depressed woman's treatment for failure to comply with medical advice and attend appointments ...Read the full article

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  1. Two Cents from Toronto, Canada writes: Ms. Matthews said: 'It took me almost three years ... before we even got a doctor and with no [warning] I have no doctor.' Well, Ms. Matthews, if you obviously didn't value the doctor, which took you too long to find. If you valued the doctor, you would not have made too many cancellations and ignored his advice. OK, you'd argue that it's not your fault because you're sick in the head. Well, your doctor can't help you if you can't even help yourself. You can't expect your doctor to go to your house just because you can't pull yourself out of bed, can you?
  2. Paul, Bytown, from Canada writes: I'm with the doctors on this one. The list are long enough that contain people who will respect their MD's full schedule.
  3. Alistair McLaughlin from Canada writes: If you continue to ignore your lawyer's advice, he/she will drop you as a client. In fact, the lawyer has an ethical responsibility to do so, if he believes that he cannot represent you adaquetly due to your non-compliance. Given the shortage of doctors, and the number of available patients who WILL follow the doctor's advice, keeping this patient around would have been a very inefficient use of medical resources. This doctor's time is better spent with cooperative patients.
  4. Lisa Poultney from London, Canada writes: All the comments so far have the 'pull yourself up by the bootstraps' mentality. Chronic severe depression is an illness. We wouldn't say to patient with a severe heart condition, 'you are dismissed because you've missed too many appointments'. There is clearly more to this than just missing appointments. Failure to comply with treatment is serious. And, finding the correct treatment that works for the patient's depression without severe debilitation is difficult especially given the way the system is set up with short appointment times and long waiting periods. Why is no one asking why there is not a single psychiatrist in London Ontario taking new patients? Why are family physicians taking the sole responsibility for treating many forms of mental illness? Why is mental illness being treated only with drugs when talk therapy is shown in research to be a necessary part of the efficacy in treatment? Please don't demean yourself and this paper with knee jerk simplistic responses to this article.
  5. Diane Mc from Canada writes: Feeling 'not important'? Aw. But I don't feel important either. I'll bet there are thousands and millions of people who don't feel important.

    Take the meds your doctor prescribed, get up, and make your own importance. Show up for appointments, and get a counsellor who knows CBT.

    There is no magic way that anyone else can put into effect to get you through this.
  6. A ZZ from Canada writes: It seems a little odd that she couldn't make appointments - not even one to determine whether she had cancer - but has no problem doing interviews with the Globe & Mail...
  7. Dan Thomas from Canada writes: What good is having the doctor if he isn't able to help her in the first place? At least he can help someone else who will accept his help. Overly simplistic? Maybe, but the fact remains, this doctors seems to feel he is unable to help the woman.
  8. Kay Ay from Canada writes: I agree with everyone! Other patients have most likely been denied appointments b/c this woman was scheduled and then she didn't show up.

    Now if the doctor just didn't like her that would be different. But if she didn't show up for a lung scan then she is not being proactive in her own health care. The doctor can't be responsible for that lack of concern.

    She still has access to walk-in clinics and hospitals so it is not as if she has no chance for further health care.
  9. Buenaventura Durruti from Canada writes: I tend to agree with most of these posts. This woman should have just switched off her mental illness to go to her appointments. The nerve of some people. I bet she'll think twice before having a debilitating bout of severe depression again!
  10. S G from A Happier Place, Canada writes: Perhaps this woman has family and friends who could help her meet her doctor's appointments? It looks like she needs some more support at home. This is important because she might never overcome her depression if she doesn't receive proper medical treatment.
  11. Ivan Highland from Toronto, Canada writes: Maybe this could be a new show for
    Donald Trump. Doctors who fire their
    patients live on television! Surprise, surprise - 'you're fired'
  12. Angus S Miskers from rainy Victoria, Canada writes: I run a dental clinic, and we have to deal with similar no-showing patients from time to time. You should know that the doctor loses plenty of money during an empty appointment: he has to pay staff, rent, utilities, and a list of other fixed expenses as long as my arm. This woman essentially is stealing his time and money, and has no respect for his commitment to the profession. When practices get too many of these types, they often resort to 'double booking' the deadbeats two-at-a-time - and the overall quality of service declines immensely. This doctor did his other patients a favour by firing this nincompoop, has preserved his quality of service, and ensured the basic viabilitiy of his business. I've done the same, and I commend him!
  13. walter hall from France writes: Unfortunately, the label 'mental illness' includes not only very clear biological illnesses like schizophrenia, dementia, bipolar disorder, but also a host of personality disorders (antisocial, histrionic, borderline, dependent, etc.). Those personality disorders tend to be the depressions that never get better despite treatment, that are repeatedly too ill to go for scheduled appointments (or even call to cancel), but nevertheless have enough energy to meet reporters and make the case that they are victims of a heartles system. Many personality disorders love the label of 'mental illness' as it validates their sick roles, absolves them of responsibility in their self care and improvement, and legitimizes their claim of disability money, support, extra privileges, 'help', etc. Not surprisingly, personality disorders in poor countries, where generous welfare and social and medical systems do not exist, manifest quite differently than in rich, well catered societies.
  14. Snowed in in Barrie from Canada writes: Maybe she could get the G&M reporter to take her to the walk-in clinic to seek help for her depression. While she's waiting for treatment she could tell the reporter how badly society treats her.
  15. R M from New Westminster, BC, Canada writes: I agree with Ms. Poultney from London, ON.
    This is a serious illness. Has anyone out there, that has been making these comments, ever suffered from depression & actually taken the medication and it's side effects? I have and it gives me the opportunity to know that it is not so simple as to just 'pull yourself up by the bootstraps'! Granted, it is worth mentioning that whenever their is a story like this, the service provider is always unable to tell their side of things because of privacy laws.
    The complainant's comments, 'It tells me I'm not worth it. It tells me I'm not important,', give rise to perhaps another story that we all know about. This is the fall of the once great health care system in Canada. You call around for days or weeks to find someone that is 'accepting' new patients. You fall ill & call for an appointment and get told that there is an opening 2 weeks from now and that you may go to your local 'emergency' if you need immediate treatment. If you show up on time for your appointment, you still wait an extra hour or two to see your doctor. If you show up to the 'emergency' room you still wait around for hours to see a doctor. God help you if it's a serious emergency or you need surgery!
    Is this kind of service acceptable anywhere else in your life? From your auto mechanic? From your tailor? From your bank? From your Realtor? Of course, this is not the fault of the physicians. However with a doctor, it's not so easy to just walk across the street and find better service!
  16. Barbara Arnelien from Meaford, Canada writes: My first thought...has the public still not realized that depression is a VERY real illness. I have read the articles,watched the news, and have heard that these were CANCELLED app. not no shows..so the Dr. did NOT suffer any time or money loss...this person also has other Dr. and that shows she is doing her best to find answers. The Dr. reason for her actions was based on this person not going for a chest x-ray, in the Dr.opnion, a timely matter..well depression has no such thing..getting out of bed can be a timely matter..after all the new over the past 5 years, have we the public still not educated ourselves at all...Depression is BIG...Boot strap pull up isn't any kind of answer...Here is a person looking for help, and we say do it yourself..is that what we do when we break a leg..shake it of and get going...I'm sure this Dr. was VERY fustrated with this lady..so be it..then I BELIEVE the Dr. responsibility was to find this lady the proper Dr..not just throw her out like dirty wash the Dr. didn't chose to look after..I have suffered this same illness, and negative comments about a sick person will do NOTHING to help..Compassion would surly be a better answer than 'boot straps' Do we tell persons with cancer 'pull your self up' ? Surly not..Lets wake up world, and see mental illness for what is.
  17. Darth Bobo from Canada writes: No sympathy from me. If you are not prepared to take the doctor's advice why bother going to him in the first place? You're just taking up valuable space in an overloaded medical system.
  18. Nancy Wilson from N.Ontario, Canada writes: All the details have not been provided in this story for anyone to make assumptions.
    We are basically hearing only one side of the story,that of the patient's.
    The Physician may have other reasons for cancelling the patient/Dr. relationship that the public is unaware of,and the Physician chooses not to disclose.
  19. A Smythers from Sudbury, Canada writes: Personally, I have been threatened to be fired as a patient for very much the same reasons. At the time, I understood the doctor's position... I mean, it's a terrible way to run a business (and it IS a business), but I couldn't help but feel like he didn't understand me at all. Then I felt alot of self-criticism much along the same lines as what some of these comments go. Like I was weak and selfish and that if I couldn't follow some simple instructions it was my own damn fault.

    Then I was professionally diagnosed - without the help of my family doctor - as having generalized anxiety disorder and there was treatment for it. It's not a quick, easy and painless treatment, but I'm getting better at making my appointments and obligations.

    Family Doctors are not magically endowed with all the medical knowledge in the world. I don't blame my GP for his threat to 'fire' me. It's too easy to blame those who are charged with fixing the most important and complex systems. It would have been nice.

    I do however, take a dim view on some of the crackpots out there who think nothing of passing some broad sweeping generalizations based on their own limited experiences. Those are the hardest things in the world to overcome. The self-righteous yet ill-informed majority.
  20. anonymouse Z from Canada writes: Bill Needle from Canada writes: The pataient is weak and stupid and deserved to be 'fired'.
    ____________

    Quite a statement. Bill, educate yourself about depression and then call someone weak or stupid.

    Depression is real and it can wreak havoc with life. The woman may not have anyone else who can look out for her either. We don't have enough information to blame either side.
  21. Emerald Matthews from London, Canada writes: Yep. I see all of your perspectives and can understand the outrage regarding 'no show's' at Dr appointments. I read your responses and wonder how no one understands the meaning of the word 'cancelled'. This is not a case of simply leaving the ever so busy Dr's hanging, it's a case of calling in advance to cancell an appointment. I do not believe that her practice suffered due to my calling in advance to cancell. I will not say that I have never missed an appointment, but how many people have forgotten about an appointment because life happens and you miss a beat? Because that is the exception to my situation, not the rule. I really also wanted to clarify that I have a psychatrist and DO NOT have a personallity disorder. I have been under his care throughout the whole time I had been seeing my family Dr. It is my opinion that she was as aware of all of the issues surrounding my situation as she could have been. Dr.'s records contain those communications. I am sorry that the majority of you seem to completely uneducated as I don't believe that you are even concidering the FACT that mental illness is not imaginary. I do take my 'meds' every day and EVERY day I do the best that I can do. I have never been looking for sympathy, but a little empathy to THE situation surrounding mental illness and society's dismissal of it.
  22. albert rose from Canada writes: Walter Hall, I was going to write the same thing. This story is just another biased story designed to denigrate doctors. People love this stuff, that's why it gets written.
  23. Ryan M from Ottawa, Canada writes: Mental disorder or not, how many hours can a patient waste of a Doctors before a Doctor finally has it. Working with the public in Finance, I know after a client has missed or cancelled numerous appointments, I'm no longer interested in dealing with them. My time is important as well, and constant cancelling shows that the client doesn't care or understand how iumportant that time is.
  24. Watson Jones from United States writes: The sad part is that someone had to wait three years to find a doctor. Even the uninsured in the US can find a doctor since they have the option to pay. Which system is more moral? Actually, let's think about this more: Canadians in need of services they can not get from their beloved 'system' or who have to wait for inordinate periods can come to the US and get care almost immediately, but can Americans get anything from the Canadian system? Hmmm...
  25. W Z from Canada writes: In order for mental illness to truly be thought of as a medical condition, patients need to treat it as such. Depression is incredibly difficult to overcome, a single action can be overwhelming, but it does not negate your obligation to do everything possible to overcome it - including seeing your treatment providers and taking your medication! Psychotic patients have more of a 'free pass' in that their thought process is impaired, but when your mind is still able to realize that you made an appointment - for your benefit - then ask for the help you need to keep it or have simply cancel it. To ignore it is to use your disease as an excuse. And yes - I've been there ... I was hospitalized, had shock therapy and have not had an issue with the depression in 14 years. I work every day to keep it at bay.
  26. Sue W from Canada writes: While I feel for this woman, more doctors should consider doing this.

    For every unco-operative, difficult patient, there's a co-operative ready to take their place.

    If this woman has difficulty keeping her appointments perhaps in the future she should consider asking a friend, or hiring someone, to remind/assist her with attending her doctors appointments.
  27. BEN DOVER from WESTERN CANADA, Canada writes: Good for the Doctor. And it isn't about money. If this Doctor is like most in Canada he has a lot of people waiting in line for him to prescribe a treatment that they will follow to help get themselves better. This isn't news. This is written for the tear-jerk effect of simple minded people. Now that Ms. Matthews wasn't satisfied with her past Doctor, let her go out and find another one. Good luck to her.
  28. Mike L. from Canada writes: Where does it say in the article that the 'cancelled' appointments were cancelled 24 hours in advance, giving the doctor the chance to fill it with someone from the waiting list? Too many people here are making too many assumptions after hearing only one side of the story.
  29. anonymouse Z from Canada writes: Watson Jones from United States writes: The sad part is that someone had to wait three years to find a doctor. Even the uninsured in the US can find a doctor since they have the option to pay. Which system is more moral? Actually, let's think about this more: Canadians in need of services they can not get from their beloved 'system' or who have to wait for inordinate periods can come to the US and get care almost immediately, but can Americans get anything from the Canadian system? Hmmm...
    ________________

    Walter, it's not like we don't have access to doctors unless we find a family doctor. We do have walk-in clinics which work pretty well for the most part. As for Canadians 'getting care' from Americans... you know, we PAY for it? Like Americans do. Americans who may want to pay for medical services in Canada can come here and get the service. I don't quite follow your point there. We are not getting service for from Americans for free. So why would you ask about what Americans can 'get' from Canada? Other than cheaper drugs, of course.

    I lived in the US for several years and believe me, there are ample who don't get help from even the hospitals there. I know a few of them since I volunteered for a school after hours.
  30. John Connor from Canada writes: It's comforting to know that Canada has no shortage of insensitive pr*ks.

    Thos of you ridiculing this woman deserve to suffer a true bout of depression. May you do so with all the indignity attached to it, soon!

    Idiots, you disgust me.
  31. gordon davies from Victoria B.C., Canada writes: It looks this person is seeking hospital care as it seems to be unable or unwilling to do for her self. There are folks that like to be ill & this sure seems to be one.
  32. Dan Thomas from Canada writes: Well, how about this for perspective then. I have a learning disability caused by a severe memory deficit. I require frequent academic coaching in order to stay organized. In college if I missed more than 2 appointments I was on my own, in university if I miss more than 2 appointments I am on my own. I can't help forgetting things, does that excuse me? No! I am still responsible for helping my self get help.

    Yes she has mental illness but I'm sorry that does not obligate a doctor who is frustrated to continue to work with her. How much is a doctor expected to accomplish when he is at his wits end? Do you seriously think it is in this best interests of the patient to have a doctor (who is only human) who may resent that he can't make progress, that is frustrated in dealing with her. You people defending the patient make the assumption that doctors somehow have unlimited patience! Get a clue, he's human!
  33. stand up mimi from Canada writes: It's pretty obvious that most people commenting here know nothing about depression. Instead of always blaming the victim, which gets so tiresome on these threads, recognize that the real culprit here is the lack of family doctors. This kind of scenario would never have happened a few years ago. I recently got a new family doctor, and was actually interviewed first before she would accept me as a patient. More and more 'problem' people will be denied access to family doctors as long as there aren't enough of them to go around. This is not acceptable in a universal health care system.
  34. Niran Sabanathan from Edmonton, Canada writes: Ultimately a person has want to help themselves. Without this desire, all the medical advice in the world is not going to help them. This patient cancelled enough appointments that the Dr. felt that he could not effectively treat her, likely using resources and time best spent with more compliant patients. The ultimate outcome, was that medical advice was not acted upon - initially by the paitent's own willingness not to comply and later by the doctor's firing; the only real difference in this situation is that the patient had no choice in the firing but had complete choice in the willing disregard of medical advice. I have never had clinical depression, so I can not truly understand the paitent's struggles. However, life, illness and handicap are never fair and the only person who is really and fully committed to your health is yourself. So, as other posters have suggested, making the effort to reach out to family, friends or even an agency to help make appointments or to search for alternative healthcare is a necessary step that has to be taken and no amount of hand wringing sympathy is going to get it done. Perhaps it is even a good thing that this person had gotten fired as they have taken one proactive step in talking to the Globe and Mail. The next step would be trying to find someone that could help them.
  35. Bill Needle from Canada writes: anonymouse Z from Canada writes: Quite a statement. Bill, educate yourself about depression and then call someone weak or stupid.

    It's called satire. You can find it in a dictionary under 'S'.
  36. Harbinger from Out West from Prince George, Canada writes: Obviously the doctor's time is valuable. Not like mine while commenting on these boards. Ha ha ha .

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