Does this sound familiar? You tell them your symptoms. They do some minimal testing, then tell you to up your antidepressant, take an anxiolytic. Further testing confirms your symptoms come from a real underlying problem.
Yes, it happens; happened to me. I was having some odd sensations in my lower leg and foot. Went to my family practice and was seen by a doctor I’d never encountered before. Described what was going on. She did a few perfunctory tests and told me there was no neurological problem; advised upping my (minimal) antidepressant dose and take an anxiolytic. Clearly she thought I was just an attention-seeking old woman making up vague symptoms.
Grrrrrrrrr! Fortunately soon thereafter I was able to see the nurse practitioner who knows me well and got an order for scanning of my lumbar area, which – golly gee! – revealed disk degeneration. The orthopedist I saw in followup confirmed the weird sensations I was feeling came from that, and we’re in the process of trying to deal with it nonsurgically.
Thank goodness my current PCP is great, as are the NPs at that practice.
In 2005, I decided to go on a war zone deployment. When I had been diagnosed with ulcerative colitis (UC) the year before, I asked my gastroenterologist (GI) whether my colitis would prevent me from deploying. He said it would not: some varieties of UC could flare up suddenly and require immediate evacuation, but the variety I had did not. As an officer in the USAF Reserve, he was able to answer with confidence, because he was familar with travel regs for deployments.
When I filled out the health questionaire for my agency’s travel medicine division, the travel doctor responded with the news that he could not approve the deployment, I informed him of what my GI had told me. The travel doc wouldn’t budge. So I asked if he would talk to my GI. I went to the travel doc’s office while my GI called him. At the end of the minute-long conversation, the travel doc turned to me and proceeded to recite the repeat the explantion I had given him, almost word for word.
Too many doctors think that unless you have the initials MD after your name, you need help tying your shoes.
Then if the doctor happens to know you have a psychiatric diagnosis, everything’s a symptom of that. If you have an undeniable physical ailment, you did it to yourself, either directly or by making bad choices. If you are complaining of a physical ailment, and there’s no undeniable physical cause, your complaining is a symptom.
For the previous few years (prior to this starting), I’d been having more and more problems with things (food/pills) getting stuck in my throat. Drinking water in an attempt to push it down just resulted in a ton of pain as my throat tried to push the water against a blockage. The only reliable way to remedy the situation was to get it to come back up. I got good at being able, to put it bluntly, make myself gag/vomit just enough to pop it out. This wasn’t psychological, it didn’t just ‘feel’ stuck and to be clear, I wasn’t ‘choking’ as it wasn’t in my airway, so I could still talk and breath, but it was painful.
In any case, I mentioned it to my ENT a few times and was essentially dismissed. He stuck a scope up my nose and into my throat and said it looked fine. I did a barium swallow and he said it was fine. He continued to dismiss my symptoms as either in my head or because I’m not chewing my food well enough.
Anyway, fast forward until it got worse and I found myself a GI doctor. I explained everything to them and they decided to do an endoscopy with dilation. When I woke up after the endoscopy I said something like ‘did you fix it?’. Their reply was 'No, your esophagus is so restricted we couldn’t get the scope down it, we’re going to borrow the scope from Children’s Hospital and have you come back in".
When I showed him the results, he dismissed those as well. They took a biopsy and it came back with eosinophilic esophagitis, but according to him, that’s just the new thing everyone is getting diagnosed with.
Yeah, and?
Saw him once or twice more after that, then stopped when he dismissed the GI doc’s recommendation that I talk to an allergy doctor and called the allergy doctor I found a ‘charlatan’.
When my husband was dying and my sister came to help me I overheard her talking to one of the too-many doctors we were dealing with about managing terminal cancer. Mind you, my sister practices in another state and was there as a family member, not in “doctor uniform”. The doctor she was talking to huffily demanded which medical school she had gone to, clearly assuming my sister was just another middle-aged biddy. Whereupon my sister told said doctor exactly which medical she had gone to, where she had done her internship, residency, continuing education… basically a run down of her credentials in minute and excruciating detail. My sister is an end-of-life specialist. Managing the dying is her bread and butter. It was an interesting conversation to witness.
But yes, I have had my medical concerns poo-poo’ed betlittled, and neglected in the past.
I have had too many doctors in my life dismiss allergies as psychosomatic, a product of hysteria/anxiety/whatever, etc. It is VERY annoying given I have at least one life-threatening allergy that has sent me to an ER on two occasions.
So its just the nature of how PCPs (GPs in British parlance) work.
Basically their job is to do one of two things:
For common simple complaints give a common simple treatment (blood pressure too high? give blood pressure medicine, allergies? allergy medicine, etc. etc.)
For anything remotely uncommon or complicated, refer to the relevant specialist.
The problem is, as almost everything they see is the first category its easy for the GP to get confirmation bias and assume, everything they see is just the common uncomplicated case, even if its not. Though, as you said, a good GP should not do that. Like, actually telling the difference between those two cases is most of their job (a teenager just out of high school can give me prescription for allergy medicine or write a referral to a oncology specialist, the reason you want someone with a medical degree and years of experience is to judge when do one vs the other)
I was diagnosed with asthma close to 30 years ago. Inhalers never helped, and never had an asthma attack. Almost 30 years of wheezing and coughing with no end.
About 2 years ago it started to feel like a valve was closing in my throat. I could get about 25% of a breath. This is a Problem. I talk to my new primary, she sends me to a pulmonologist. Pulmonologist says lungs are fine, and after 2x pulmonary function tests, I don’t have asthma. You can’t breathe because of anxiety. Um, excuse me? Yep, it’s anxiety. Remove stressors and your breathing will return. Listen, my life is more easy going now than any time in the past 15 years. Did you look at my throat? No, but I suppose I could send you to an ENT, but they aren’t going to find anything.
I was in the ENTs office for 5 minutes, she said she knew what the problem was, and is going to stick a camera up my nose to show me. She put my larynx on a 22 inch HDTV and told me to take a deep breath. My larynx slammed shut. There’s your problem, the valve is closing. Then she showed me the inflammation and mucous I’ve been feeling for decades. Gastric reflux irritates my larynx, which slams shut when irritated by a deep breath. Lets fix your gastric reflux and re-teach you how to breathe to slow things down.
Anxiety? Easy way out and 100% wrong. I’m glad we didn’t start medication for that.
Amazing doctor who knows what she’s doing? Fixed 30 years of breathing problems and increased my quality of life immeasurably practically overnight.
Look, everyone knows that the following are just drug seeking attention seeking hysterical hypochondriacs;
old people
young people
everyone else
sick people
/S
I didn’t get to witness it, but I wish I had seen the smackdown a neurology resident doctor got for overlooking a possible GI bleed in a stroke patient by a veterinarian family member.
Allegedly, the vet noticed a change in behavior, reduced cognitive function day over day, noticed a nurse’s comment of “dark stools” in the chart, and proceeded to absolutely destroy the resident for not understanding that this patient was bleeding out.
“I may not be a doctor like you, but I graduated top of my fucking class, and I know a bleed when I see it.”
I believe the vet stopped short of announcing what needed to be done next, but not only were they correct, the bleed was severe enough to warrant minor surgery in addition to several units of blood.
I have a ton of respect for doctors and nurses, and it’s not always arrogance that makes them like this: it can be fatigue, overwork, complacency, etc. But when someone insists something is wrong the doctor - and the system they work in - should be enabled to really explore that and solve it. I’d rather start at the system level; more funding, resources, time per patient etc.
I live in fear of dismissive doctors. So far, I’ve mostly been lucky. Some of these stories are horrible.
Having had a less-bad variant of the same problem, I diagnosed you right there. Holy shit, your ENT should have sent you to a gastroenterologist right away.
Holy fucking shit. My mother’s home aid recognized that these were symptoms of my mom having a GI bleed. She described it to me, and I described it to my mom’s doctor, and we had a serious conversation about whether it was time to let mom die (which she was ready to do) or whether she should get treatment. They ended up treating her, also with a couple units of blood and a procedure to stop the bleed. It was successful, but perhaps not the right choice, given her quality of life between then and her painful death a couple months later. But at least the doctor took her symptoms seriously.
Good for her. I once had a doctor ask me that. I should have gotten up and left right then and there. What an asshole thing to say.
I took my German Shepherd to the vet. My regular vet was out, and we saw a young vet, just out of vet school. Mike had suddenly gotten very lame in the back end, very suddenly. I told her I thought is was possibly a spine issue, something neurological. I saw her put "client thinks it’s “neurological” (in quotations) in his chart and dismissed that out of hand. She told me no, it was arthritis, put him on Rimadyl and he’ll be fine. He started losing weight after being on the recommended dosage of Rimadyl. I took him in and my old vet was there. She said the Rimadyl had given him a bleeding ulcer, and after doing some physical exam said he probably had a disc injury. I ended up have to put him down, all because a vet didn’t recognize my lifetime of dog experience.
I personally told my doctor at my most recent physical that I had lower pelvic pain daily, for hours each day, which I thought might be gastro. I’ve had this, getting worse, for years. I don’t go to the doctor, so if I actually have a complaint, it’s because it’s serious enough to disrupt my life. She ordered a CT scan, which was unremarkable, but didn’t have anything else to try. I did go to a CI doctor, had a colonoscopy (time for my regular), a small polyp, but nothing. I made an appointment to discuss the pain, and was seen by the nurse-practioner. tried a couple meds, a barium swallow, still nothing. Still in pain, no other things given to try, and never did see the doctor.
The trick to getting a doctor to take you seriously is that you must show you’ve done your homework. Use the clinical-sounding terms, like peristalsis, fissure, traction, etc. rather than just “hurt, crack, bump,” casual language.
My sister is a nurse who has worked in varied and intense positions throughout her career. Her own health issues are keeping her from working now. When she needs to she can turn it back on. I’ve seen it when I had some issues and I saw it throughout my mother’s cancer journey. She has a talent for subtly letting doctors know her background almost without them noticing. It made all the difference in the world. At the same time I saw people going through their issues with no one advocating for them. It’s a nightmare.
“I think Mr. Hunter is intellectualizing again, do we all agree? Hey, you may be able to bamboozle your friends with that big-word shiny bullshit but that isn’t gonna fly in here.”