Open complaint to College of Physicians and Surgeons of Ontario

I have filed the following complaint to the College of Physicians and Surgeons of Ontario, and am making that complaint a matter of public record by posting it here on my blog.

NB: This post has been edited from the original letter, omitting names of the physicians.

re: ————————————————————————————–

Overview

I first saw Dr. ——- October 7, 2013 as a new patient. Although very pleasant, from the outset it was clear Dr. ——- was determined to recommend not only outdated and ineffective practices regarding obesity, but cast into doubt the veracity of any of my statements.

The appointment was concluded, and I was told to book another for follow-up, which I did.

The second appointment took place on October 21. I was immediately informed this appointment was to be a complete physical, with an array of blood and urine tests to follow, none of which I had consented to undergo. I refused the physical, and obtained prescriptions for rampipril 10mg, and atenol 50mg, prescribed by my former physician for hypertension.

I made a third appointment which took place November 8, at which time Dr. ——- terminated our doctor/patient relationship.

Areas of Concern

No understanding of, or sympathy with, the dynamics of chronic pain

I deal with chronic pain from both osteoarthritis and sciatica.

Around 2007 I was treated by Dr. ———— in ——- for osteoarthritis and sciatica, which resulted in long-term prescription of Tylenol 3, 30mg, to be taken as required, not to exceed six tablets/day. I usually only took 2 tablets before bed in order to dampen the pain enough and allow me to fall asleep.

In 2009, I was treated by Dr. ————- for osteoarthritis, with the end result he prescribed 375mg naproxen twice daily in order to better address arthritis pain, with full knowledge of my hypertension and medication history. The result of that treatment resulted in a dramatic improvement in my quality of life.
I continued to take T3s when necessary at night, as Naproxen does not address nerve pain.

Upon my first visit with Dr. ——-, he immediately told me to discontinue use of Naproxen because it can elevate blood pressure. I asked how I was to deal with the pain of arthritis, and he had no answer, and instead discussed obesity. I subsequently refused to discontinue use of naproxen, knowing without it my daily mobility and function is greatly impacted.

My third visit to Dr. ——-was to refill my prescription for T3s, and to give him a copy of the medical report I’d received from Dr. ————- regarding his diagnosis and treatment for my arthritis. At that time, I also gave Dr. ——-a detailed chart of my daily food consumption, with daily blood pressure and pulse records, to prove his assertions of over-eating were erroneous, and that at home, in a stable, controlled environment, my blood pressure is within acceptable levels.

Dr. ——-became quite incensed when he glanced at Dr. ——– report, and even further incensed when he read my daily record. When I then asked for a prescription renewal of T3s, he vehemently, even angrily, stated he would not prescribe narcotics. I asked how I was to manage sleep without pain relief. He stated I was already on naproxen. I pointed out naproxen addressed arthritis pain, but would not touch nerve pain from sciatica. It was then Dr. ——- tossed the reports back at me and stated our relationship is over.
It became clear to me that because I had refused to accept his path of treatment, and his dismissal of my chronic pain difficulties, that Dr. ——- would brook no questioning of his authority. A patient has a right to access an informed, understanding physician, without prejudice or bias. It is clear Dr. ——- is incapable of accepting a patient’s will, and is lacking in understanding in the area of treatment of chronic pain.

Adherence to outdated practices regarding obesity

During my first visit with Dr. ——-, he naturally focused on the fact I am obese. Quite understandable. However, he immediately zeroed in on the highly questionable (and now under intense research and investigation) theory of thermodynamics, and made it clear he doubted my veracity when I asserted I do not over-eat, the fact I’m obese is not a matter of quality or quantity of food. I explained I have been either over-weight or obese all my life, that even on 600 calories a day and vigorous exercise I can still gain weight.
Because of his dismissal of my assertions, he then wished me to see a bariatric surgeon. I emphatically refused. He asked why, and I responded the research clearly indicates bariatric surgery is ineffective over the long term, quite outside of the enormous monetary consideration for treatment not covered by government health care, and often the equivalent in cost of a very expensive new vehicle. I was not prepared to mortgage my home for treatment clearly proven ineffective.

Dr. ——- then asked if I have difficulty sleeping, which I confirmed, adding pain was usually the reason. He ignored the latter and asked if I snored. I confirmed that from time to time I snore, especially when over-tired. He then asserted I snore because I’m obese, and he wished me to see a sleep therapist in order to address sleep apnea. He further asserted I’m obese because I snore (bit of circular thinking there), because if I wasn’t sleeping, I was eating. I made it clear I remained in bed and read when I couldn’t sleep, which he dismissed. Again, I refused to see a sleep therapist, because, quite frankly, by this time I suspected the snake oil was going to come out at any moment, you will please pardon the unprofessionalism of that statement.
I asked Dr. ——- if he had read any of the current research regarding obesity, in particular:
and:
or if he’d read the fascinating research presented by Gary Taubes in: Good Calories, Bad Calories.

The answer to all of these was no. So, it was clear Dr. ——- was simply repeating outdated, ineffective, uninformed and sometimes dangerous medical practice, rather than pausing to consider the most recent research into this global problem.
Frankly, I’m weary beyond expression of doctors who simply will not listen to patients, who are not keeping current. And Dr. ——— dismissal of any of my statements was an expected and disappointing repeat.

No respect for patient’s wishes

After these three visits to Dr. ——-, and his subsequent refusal to treat me, it is clear he will brook no disagreement with his authority, his opinion, or his theories. I am tired of being poked and prodded for tests which will come back negative. I am tired of doctors looking for diseases which I don’t have. I am tired of doctors looking at me like I’m a revenue generator. And I’m tired of doctors calling me a liar, albeit in very politic and polite terms.

It is clear Dr. ——-is no exception from what has become the norm in the paradigm of medicine. When the Hippocratic oath was replaced with imperative of profit and business, patient care went out the window. I imagine if I had been like so many other patients, and particularly female patients, and simply accepted his statements as truths, never questioned, never bothered to research my own health and conditions, I would still be under his care. But I’m not. And despite the fact I am once again without a physician, there is a relief, also, that comes with knowing I won’t have to deal with someone so autocratic and ignorant.
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