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<blockquote data-quote="Marguerite" data-source="post: 12956" data-attributes="member: 1991"><p>I've always said - where possible, work with the doctor you have. Work as a team. If you disagree, discuss it. Try to work it out. </p><p></p><p>If after a lot of effort you still feel there is no chance of a useful working relationship and viable treatment, then move on. If at a later stage you get what you were looking for - something that works in a professional relationship to the patient's benefit - then feed that back to the first doctor so they know you weren't just another doctor-hopping patient.</p><p></p><p>Continuity of care is most important, for a number of reasons:</p><p></p><p>1) It makes it easier to recognise and learn from long-term patterns; </p><p></p><p>2) Ongoing issues can be better monitored with a long-term history (ie blood tests being abnormal here or there), making it easier to test and eventually discover a possible cause for sub-issues, at least</p><p></p><p>3) It shows you are prepared to face unpleasant suggestions and at least consider them, rather than always walk away when someone offends you.</p><p></p><p>4) A patient who shops around constantly can risk being labelled as Munchhausen's. A parent who shops around and gets this label can lose their kids. I've seen it happen.</p><p></p><p>A woman I knew had a daughter with a 'mystery illness'. She was a member of an organisation which had people with similar health problems, an illness that was still considered by some doctors to be imaginary. The mother became focussed on 'proving' her daughter was genuinely physically ill. She had the best specialist in the world (according to most opinions). I had the same specialist. Then the specialist began suggesting to his patients that we be assessed by a psychiatrist to determine any possible problems due to being ill long-term. I wasn't happy with this but agreed. I disagreed and argue with the psychiatrists but they fairly soon left me alone - any problems I had were under my control, there was nothing requiring their services. But this mother - she withdrew her daughter from this specialist loudly, in protest. "How dare you doubt my daughter!"</p><p>The problem was, because this specialist was such a trend-setter, all other similar specialists began introducing psychiatric assessment as part of their work-up. The mother was dragging her daughter from one doctor to the next, until she found one who would not insist on her daughter seeing a psychiatrist.</p><p></p><p>Finally, after ongoing problems which were hard to assess because the medical records were not passed on (the mother refused to bring records from past doctors, because in her view the past doctors were all completely wrong) the girl was in hospital. By this stage I had also been cut off from contact and information, so all I know is what I have been able to glean from others - the girl was in hospital, very thin and weak. She was on IV fluids for nourishment and hydration. The hospital requested a psychiatric evaluation. The mother had the girl discharged. The girl later died at home (under medical care of sorts). The mother ordered an autopsy at her late daughter's request. The autopsy would have proved, she believed, that this was a physical problem. However, I was never able to discover the results. I believe, with all the poor girl went through, they could well have been inconclusive. In the same way that long-term physical illness WILL cause some level of psychiatric dysfunction, long-term physical illness also leaves its own physical ravages which can mask an original, subtle cause. Who knows?</p><p></p><p>The girl could well have died anyway - I'm not saying she died because her mother dragged her from pillar to post. But I believe she would have had a better chance if they could have let the shrinks see her and then having realised she WAS physically ill but coping emotionally, leave her to be perhaps more appropriately managed by the same long-term specialist.</p><p></p><p>Another example (sorry) - difficult child 1's first pediatrician diagnosed him as ADHD when he was 6. He was helpful, he even came out to the school and talked to the staff about difficult child 1's needs and about ADHD in general. But then he began to change. he began to make appointments with me, said I didn't need to bring difficult child 1 (who WAS the patient, after all) and began to be very interested in my mental health (interestingly, at the same time as my specialist wanted me to be checked over by a shrink). So, with pressure on all sides from MY doctors, I saw the psychiatrists. When I went back to the pediatrician who was STILL harping on about my mental health, I told him the results - "They said I had depression in the past but had dealt with it appropriately and it is not currently a problem."</p><p>His reply - "Wow, you must be really mentally sick, if you could fool them that well."</p><p>The pediatrician had also begun to insist I see him alone. One day I had made an appointment on one of husband's rare days off, as he IS the child's father! As soon as the doctor realised husband would be there too, he cancelled the appointment.</p><p></p><p>I worked at that parent-of-patient/doctor relationship but it became increasingly bizarre and inappropriate, so I made a clear break and moved on, making sure I told the new doctor as much as I could and also asking for the case notes to be forwarded. I knew the notes would have some bizarre things about me but I did my best to explain to the new doctor a bit of the history. Fortunately, the old doctor had a history of his own and an increasingly shady reputation. The new doctor took me on my own merits and made up his own mind.</p><p></p><p>So while you should TRY and stay with the same doctor even if you fight occasionally, sometimes you HAVE to move on. The thing is, you try, you make an effort then you make a considered judgement. You then assess, after the fact, the outcome on your child - did I make a mistake after all? Should we go back? or are things much, much better?</p><p></p><p>We each have our own situation to work with. But you guys here help stiffen my spine. Thanks.</p><p></p><p>Marg</p></blockquote><p></p>
[QUOTE="Marguerite, post: 12956, member: 1991"] I've always said - where possible, work with the doctor you have. Work as a team. If you disagree, discuss it. Try to work it out. If after a lot of effort you still feel there is no chance of a useful working relationship and viable treatment, then move on. If at a later stage you get what you were looking for - something that works in a professional relationship to the patient's benefit - then feed that back to the first doctor so they know you weren't just another doctor-hopping patient. Continuity of care is most important, for a number of reasons: 1) It makes it easier to recognise and learn from long-term patterns; 2) Ongoing issues can be better monitored with a long-term history (ie blood tests being abnormal here or there), making it easier to test and eventually discover a possible cause for sub-issues, at least 3) It shows you are prepared to face unpleasant suggestions and at least consider them, rather than always walk away when someone offends you. 4) A patient who shops around constantly can risk being labelled as Munchhausen's. A parent who shops around and gets this label can lose their kids. I've seen it happen. A woman I knew had a daughter with a 'mystery illness'. She was a member of an organisation which had people with similar health problems, an illness that was still considered by some doctors to be imaginary. The mother became focussed on 'proving' her daughter was genuinely physically ill. She had the best specialist in the world (according to most opinions). I had the same specialist. Then the specialist began suggesting to his patients that we be assessed by a psychiatrist to determine any possible problems due to being ill long-term. I wasn't happy with this but agreed. I disagreed and argue with the psychiatrists but they fairly soon left me alone - any problems I had were under my control, there was nothing requiring their services. But this mother - she withdrew her daughter from this specialist loudly, in protest. "How dare you doubt my daughter!" The problem was, because this specialist was such a trend-setter, all other similar specialists began introducing psychiatric assessment as part of their work-up. The mother was dragging her daughter from one doctor to the next, until she found one who would not insist on her daughter seeing a psychiatrist. Finally, after ongoing problems which were hard to assess because the medical records were not passed on (the mother refused to bring records from past doctors, because in her view the past doctors were all completely wrong) the girl was in hospital. By this stage I had also been cut off from contact and information, so all I know is what I have been able to glean from others - the girl was in hospital, very thin and weak. She was on IV fluids for nourishment and hydration. The hospital requested a psychiatric evaluation. The mother had the girl discharged. The girl later died at home (under medical care of sorts). The mother ordered an autopsy at her late daughter's request. The autopsy would have proved, she believed, that this was a physical problem. However, I was never able to discover the results. I believe, with all the poor girl went through, they could well have been inconclusive. In the same way that long-term physical illness WILL cause some level of psychiatric dysfunction, long-term physical illness also leaves its own physical ravages which can mask an original, subtle cause. Who knows? The girl could well have died anyway - I'm not saying she died because her mother dragged her from pillar to post. But I believe she would have had a better chance if they could have let the shrinks see her and then having realised she WAS physically ill but coping emotionally, leave her to be perhaps more appropriately managed by the same long-term specialist. Another example (sorry) - difficult child 1's first pediatrician diagnosed him as ADHD when he was 6. He was helpful, he even came out to the school and talked to the staff about difficult child 1's needs and about ADHD in general. But then he began to change. he began to make appointments with me, said I didn't need to bring difficult child 1 (who WAS the patient, after all) and began to be very interested in my mental health (interestingly, at the same time as my specialist wanted me to be checked over by a shrink). So, with pressure on all sides from MY doctors, I saw the psychiatrists. When I went back to the pediatrician who was STILL harping on about my mental health, I told him the results - "They said I had depression in the past but had dealt with it appropriately and it is not currently a problem." His reply - "Wow, you must be really mentally sick, if you could fool them that well." The pediatrician had also begun to insist I see him alone. One day I had made an appointment on one of husband's rare days off, as he IS the child's father! As soon as the doctor realised husband would be there too, he cancelled the appointment. I worked at that parent-of-patient/doctor relationship but it became increasingly bizarre and inappropriate, so I made a clear break and moved on, making sure I told the new doctor as much as I could and also asking for the case notes to be forwarded. I knew the notes would have some bizarre things about me but I did my best to explain to the new doctor a bit of the history. Fortunately, the old doctor had a history of his own and an increasingly shady reputation. The new doctor took me on my own merits and made up his own mind. So while you should TRY and stay with the same doctor even if you fight occasionally, sometimes you HAVE to move on. The thing is, you try, you make an effort then you make a considered judgement. You then assess, after the fact, the outcome on your child - did I make a mistake after all? Should we go back? or are things much, much better? We each have our own situation to work with. But you guys here help stiffen my spine. Thanks. Marg [/QUOTE]
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