When Doctors Discriminate
I am a person with chronic pain. I have an obscure malformation in my neck that causes a lot of problems due to its placement in a busy area. It can’t be fixed. They already tried. b I happen to also have a graduate degree in a field that makes me something of an expert on my syndrome, in addition to being an expert just from the experience of having it.
I also have an anxiety disorder that’s not unrelated to having an obscure malformation and a lot of mysterious symptoms for years before it was actually diagnosed.
I manage my pain with chronic pain medications such as antidepressants and anticonvulsants (which are first-choice treatments for neuropathy). Unfortunately my psychiatrist does not feel qualified to increase my medication for anything besides psychiatric reasons. So if I feel like my antidepressant is no longer managing the neuropathy, I have to wait until the pain gets bad enough that I can reasonably say I am depressed or anxious about it.
At the same time, my primary doctor, who originally prescribed the antidepressant to treat my neuropathy, does not feel qualified to comment on the antidepressant, because my psychiatrist is prescribing it now due to needing a higher-than-typical-for-neuropathy-only dose, and it’s also a psych med so the psychiatrist has experience with it.
Maybe you’re starting to see the problem.
My psychiatrist has told me I cannot raise the antidepressant until I see her in 2 months, despite the fact that I am having increasingly severe pain and spasticity, as well as the weirdo symptoms that go along with cranial nerve neuropathy (ear pain, loss of sense of taste, etc.). She urged me to contact my primary doctor. My primary doctor just informed me that if I want short-term opiate pain management, I need to go through the chronic pain program, simply because I am a chronic pain patient. I have never asked this doctor for an opiate prescription, and in fact the last time I had such a prescription was in 2013 because, it turns out, usually the regular meds are plenty.
This is what casual disability discrimination looks like. If I were any other patient with no established history of pain medication abuse, who’d had no opiate prescription in over 2 years, who just needed something to have on hand for breakthrough pain to get through the next 2 months until my appointment with a specialist, I would not be sent to a program whose purpose is to manage people whose pain is severe and uncontrolled enough to require round-the-clock opiate pain management. And as I write this, I sit here on hold with member services for an HMO that is in the news a lot this month for serious delays in patient care, where I’ve been for an entire half-hour, waiting to ask someone if there is a doctor in their network who can treat me as a WHOLE patient.