Learning to treat patients with respect

By Lydia Jade Turner

Last month, a woman in her early twenties contacted me, distressed upon witnessing the mistreatment of her housemate by an Emergency Medicine Specialist. Her housemate Joanie*, also in her twenties, had just been admitted into hospital following a serious suicide attempt.

What follows is an excerpt from a letter of complaint written by Anna* to the directors of a prestigious public hospital in Sydney. The hospital has since sparked an internal investigation:

“… this doctor … repeatedly called [my housemate] “Cassie” despite numerous corrections made by both Joanie and I.

While one of the nurses was inserting an intravenous cannula (IVC) into Joanie, this doctor came past to use some of the equipment off the trolley. She remarked to the nurse “stupid fucking overdoses, waste of my time” right in front of Joanie – unaware of her reason for admission. When she eventually came around to see Joanie, she was incredibly patronising in her tone. She asked Joanie’s medical history, which Joanie was not able to complete so I filled her in.

On telling her that Joanie had struggled with anorexia nervosa and bulimia nervosa, she asked Joanie if she’d ever been in hospital with the condition. Joanie had not and told the doctor she had received outpatient support co-ordinated by her GP. Following this response, this medical officer (MO) stated “well it wasn’t real anorexia then was it dear?”

Not only was this statement invalidating, but my housemate already struggles to accept she has a genuine eating disorder. Joanie also expresses shame at the fact that she is not “thin enough.” Since that night, Joanie has continuously stated that “food is not a problem for [her]”, despite engaging in repeated purging, exercise and restrictive behavior.

Joanie feels that as she no longer meets the weight criteria for anorexia nervosa as she once did, and having had her condition dismissed so easily, that there’s nothing wrong with her. She has told me repeatedly that “if a doctor says I don’t have an eating disorder than I mustn’t” – besides having a diagnosis of EDNOS from a psychologist and her own GP.”

Clearly this MO has absolutely no training in eating disorders, and very limited training in mental health. For an emergency department MO, this is entirely unacceptable, especially for a hospital like [named removed].

Following on from this, I expressed concern for Joanie’s safety as, had I left, she would have been left alone in the Acute section of the emergency department – with railings, a very sharp, serrated edge on the tap broken in the bathroom, oxygen tubing and other wires – just to name a few of the hazards to an acutely suicidal patient.

Joanie had repeatedly expressed a desire to pull her IVC out and had collapsed when I helped her to the bathroom (with permission from a nurse). I asked the doctor if it was possible for a “special nurse” (IPS) to be provided for Joanie as I didn’t feel she was safe. The reply I got was “well dear, if you’re that worried about her, you’ll stay, won’t you.”

At this I feel it important to mention that a) it was 2am and I hadn’t slept since the night before b) I am not trained to look after acutely suicidal mental health patients c) I am Joanie’s flatmate and friend, NOT her carer d) This doctor had done absolutely no assessment of Joanie’s safety.

I found it a highly inappropriate response for her to assume that I would assume responsibility for Joanie’s wellbeing. To push me into a role of carer is an entirely inappropriate course of action. She did not ask me how I would feel about that, or if I would be able to do just that. Had she enquired into Joanie’s psychosocial history, she would have found that I struggle with chronic illness myself and am not in a state to become Joanie’s carer, or her IPS.

…I found [the doctor’s] conduct remarkably unprofessional. A mental health patient is still a patient and thus should be treated with the same respect and dignity of any other patient…”

It is unfortunate that the attitude displayed by this particular doctor towards Joanie is not rare. While it’s important to recognise that health professionals are only human and will, from time to time, make mistakes, some ‘mistakes’ are not acceptable. It is never acceptable for health professionals to laugh at patients behind their backs, call them names, or speak abusively towards them.

When health-care providers treat their patients with contempt, with or without their patients’ knowledge, it bears significant consequences. For example, a study of 498 women published in 2006 in the International Journal of Obesity, showed that obese women were more likely to postpone cancer screenings compared to thinner women, citing doctor’s disrespectful attitudes as a significant reason.

Negative attitudes towards patients makes it easier for practitioners to ‘write them off,’ and enables minimal effort to assist the patient. Patients are also more likely to avoid check-ups and treatment – sometimes even leading to patient death.

While it seems most health professionals do treat their patients with regard, it’s important to know your rights and to take action should you or your loved one experience mistreatment, such as in Anna’s case above.

So tell us, have you ever been disrespected or mistreated by a health professional? What did you do about the situation and what impact did it have on you?

Also see http://www.dailytelegraph.com.au/news/doctor-in-online-tirade/story-e6freuy9-1225939622504