PCOS isn’t a real disease, it’s made up by fat women.

Susanne writes:

From 1999-2001 I was suddenly health insured again and although I was living about 150 mi away from the specialists I eventually needed to see, I decided to have a thorough checkup. I am significantly overweight and qualify as morbidly obese; strangely, most doctors observe, I don’t seem to have the expected health problems from it, but for various reasons I wouldn’t mind losing about half of my body weight, which would still make me overweight, but not as much. I’d like to be able to buy clothing in a local clothing store, and I guess I admit I’d like people not to stare at me on the street. Three different diets didn’t help much (20 pounds off), and the exercise typically recommended for people in my situation didn’t seem to impact me much, either. The results of that push to get treated were, after many trips back and forth, a doctor supervised diet and exercise plan, a lot of tests, a few procedures, a preliminary diagnosis of PCOS. Just as I was ready to start treatment for that, I had to change jobs and move about 1,000 miles away to a different city. When I changed jobs, I had a six month exclusion of treatment on my new policy for anything that was a pre-existing condition. After the six months were over, I went to a gynecological practice that was recommended univocally by a number of my new female colleagues. I was lucky enough to have doctors in the first city who gave me a copy of all the test results and treatment attempts, and I took this file of paper along with me expecting to pick up where I had left off. I have never been so humiliated. A robe that covered a third of my body, a nurse who addressed me by my first name in a town and culture where the usual form of address is Ms or Mrs., insulted me by telling me straight out that my stomach is disgusting, and then read my blood pressure four times because she didn’t believe anyone at my weight could have a bp of 120/90, and a gynecologist who took one look at me, and even before doing the basic gynecological check, started a checklist of new procedures she wished to perform on me because something was wrong (as I stated that I had irregular, weird periods). “I am going to give a prescription to start your period immediately, you should probably go on birth control, you will have to have an immediate biopsy, and let’s see, we’ll start with thyroid”…and my reply was “actually, I have been through a lot of this already, my most recent result for thyroid problems was negative” and she said “how do you know that?” and I pulled out my folder of two years of testing. I said, “you may want to look at these. My last doctor had just arrived at a diagnosis of PCOS when I had to move.” The reply? “PCOS isn’t a real disease, it’s been made up by fat women.” I said, “I just had a biopsy about eight months ago,” and she said, “we can’t trust the results of those tests. If they told you you have PCOS they are quacks and are not interpreting the results correctly. You need to do what I say.” I said, “you know, I am not three years old. I have been reading medical materials since this diagnosis showed up on the horizon, and I think PCOS is a pretty well accepted phenomenon, you can question whether I have it, but I don’t think you can question whether there is such a thing as PCOS” and she said, “why are you reading medical materials? You can’t possible understand them,” and I said, “I have a Ph.D. I may not understand everything, but I am capable of understanding a lot” and she said, “well, you are NOT a doctor.” Realizing we weren’t going anywhere, I said, “can we complete the physical exam?” There was some issue with how the speculum was angled (she didn’t seem very experienced in performing the procedure) and she said, “stop bearing down!” and I said, “I am not bearing down” and she said, “well, who would have thought your vaginal muscles would be so strong. You can’t be having much sex.” (Note: I had indicated on the form that I am sexually active with my partner. I guess she didn’t believe anyone as disgusting as me could be telling the truth.) I thought this wasbeyond the pale and I said, “would you please complete the exam?” I left the office shaking.

Two days later the practice nurse called back to schedule all of the tests that this doctor had ordered. I said, “I will not be scheduling tests with your practice, after my insulting experiences in your practice, I am not sure that you or the doctor is competent” and she said, “you just can’t stand it that someone is finally telling you the truth about your weight.” And I said, “no one knows the truth about my weight better than me. I am the one who lives in my body, thank you very much.”

Thank you to the doctors in the first city who didn’t assume I was just a lazy pig. I stood up for myself with this new practice, but I doubt it had any effect on them. And I haven’t been to a doctor since then. I wish I could get the courage to find another gynecologist, but I can’t risk this kind of treatment again. It made me feel suicidal for weeks. I am pretty sure I had cyst rupture last week. I know I should find a new doctor. But I am at a crucial point in my work and I can’t risk the emotional disequilibrium. I am shaking just writing this.

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Battling medical bullies

MSNBC.com has a story out today on ‘medical bullies’ – medical professionals who browbeat patients, ignore questions, act impatient, insult patients and/or colleagues or even yell, cuss and throw things.   Now the Joint Commission, a national hospital accrediting agency, warned that there’s mounting evidence that such disruptive behaviors are tied to medical errors that can cause patient harm — and called on hospitals to adopt a no-tolerance policy.

Starting in January, the agency will require hospitals to establish codes of conduct that define inappropriate behaviors and create plans for dealing with them. Suggested actions include better systems to detect and deter unprofessional behavior; more civil responses to patients and families who witness bad acts; and overall training in “basic business etiquette,” including phone skills and people skills for all employees.

The AMA has had a policy calling for zero tolerance for disruptive behavior for all workers for years.  The Joint Commission standards and suggestions will offer hospitals a clear model for establishing guidelines and consequences that will help decrease disruptive behavior.  Official warn that it could take years however for a major culture shift.

The MSNBC story includes a sidebar on bullying behaviors.  How many reader submissions featured here echo the very same behaviors listed?