Navigating care as an MD-patient

Issue: BCMJ, Vol. 60, No. 2, March 2018, page(s) 80,82 Letters
C.P., MD

I am a practising physician in BC with chronic illness. It is not unusual to come up against conflict in communication and advocacy with my care providers. I have come to realize that this unique relationship between an MD-patient and the care provider of an MD is insightful but at times challenging and stressful.

When conflict arises, I ask myself, “How would it have been different if I were not a doctor?”

A few weeks ago I had one of the more stressful encounters when I felt my psychiatrist was more concerned about protecting her relationship with her colleagues on the inpatient side, who took care of me during a hospitalization, than being my advocate first and foremost. There were adverse outcomes and her postdischarge follow-up note was sparse in details of the events. I felt a more detailed documentation of my concerns would have helped to improve future care.

The challenges of being an MD-patient is more prominent when a doctor is hospitalized. I remember once, after complaining to nursing staff about how they handled a patient in crisis whom I had befriended during my inpatient stay, the head nurse telling me in dismay, “If you think you can do better why don’t you come and stand here and manage the unit?”

I often walk a thin line in maintaining boundaries and taking the patient role. I feel we, as doctors, are ill prepared for this role in our medical school training, despite the fact that most of us work well into our 60s and 70s and eventually face our own chronic illnesses.

I believe it would be so helpful for doctors with chronic health issues to support each other with similar challenges. Over the years, I have looked into the Physician Health Program in BC to see what services and supports are offered. There is much to learn from being “in the same boat.” Disappointingly, the PHP position has focused mainly on one-to-one private consultation and referral. There was a community-based initiative, but no significant effort to create a province-wide peer-support program, which has been successfully set up in many countries such as the UK. These programs are relatively inexpensive to set up as private chat rooms governed by the doctors’ associations. This is of particular importance in BC where some doctors are more isolated in the central and northern regions. When I approached the Physician Health Program in BC some years ago, they expressed some interest but said that due to limited funds they have prioritized physician-resiliency initiatives.

I continue to wait for the day when doctors with chronic illness in BC become a priority for enhanced supports. We are in an era of fighting stigma and this has to start from our own institutions, regulatory bodies, and most importantly the support of our peers. We encourage our patients to access such programs, yet we shy away from creating one for us.
—C.P., MD


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