I was just 'triaged' by a specialist i was refered to and she has refused to see me.
how often does this happen?
what are the reasons for it?
Doctors Refusing to See Particular Patients
bargain huntress on 19/01/2021 - 22:37
Comments
Usually when they fear for their safety as the patient may have issues of anger etc ?
ok, but how would a doctor you have never seen have any idea if you were dangerous?
or they don't think you need their particular service
ok, but if you didn't need their service, why would you have been referred to them?
Aggression alerts can be placed on electronic medical records by hospital staff
Aggression alerts can be placed on electronic medical records by hospital staff
what about for private referrals?
@bargain huntress: Records are always sent with referrals for background on the patient.
So you have been aggressive with medical staff?
@bargain huntress: Nobody should have to deal with aggressive people, let alone “be used to that kind of thing”…
Nobody should have to deal with aggressive people, let alone “be used to that kind of thing”…
no,
but there are many neurological disorders with symptoms of agression, impared impulse control, etc
thus i said;
But I would have thought a neurosurgeon would be used to that kind of thing?
and am being negged by people who have no idea how the brain works
if you don't believe me; go sit in the waiting room of a neuro department at a hospital for a while, you'll see
and am being negged by people who have no idea how the brain works
Pretty much. Ozbargain has turned into a toxic community of close-minded people who don't like different opinions or facts.
Think with the mob or get out is pretty much the new mantra here.
I don't know
Yes, you do. A family member actually told you that you're being aggressive. See below.
One person in my family has told me the way I talk lately sounds aggressive sometimes
And what have you done about that so far?
Yes, you do. A family member actually told you that you're being aggressive. See below.
ok you're right
And what have you done about that so far?
i keep asking about it, i've asked my psychologist and gp about it multiple times but they haven't suggested anything, nothing like anger management or anything, they just start talking about medical stuff like sending me to this neurosurgeon who then wouldn't see me
i don't know what to do
@bargain huntress: Have you already looked at being referred through the public system?
There are often long waits if it’s not triaged as urgent but depending on what your issues are (not sure if it’s a brain or spine issue) some health services will divert referrals that might benefit from a different approach (eg physiotherapy review) at time of referral. If it’s a suspected brain issue that’s impacting your behaviour/thinking I would guess it would be triaged more urgently (if not a known chronic issue), but I would have assumed you would have had some brain imaging done already and the GP would have told you what it is they are referring for surgical opinion if this is the case.
Presumably the GP is thinking it might be something to consider if surgery will help, hence referring to a neurosurgeon. Irrespective of whether it’s a brain or spine issue, surgery may or may not be the answer. It may be that the surgeon has already identified this from the referral (or not a type of surgery they do) so it would be good to get that feedback on reason for not accepting the referral. For most things that would warrant referral to a neurosurgeon a non-surgical health professional is also likely to part of the picture with or without surgery, eg pain specialist, rehabilitation specialist, oncologist, neuropsychologist, physiotherapist, occupational therapist… just depending on what the issues are, this could be post surgery or if surgery is not warranted/an option. Often though the GP wants to get the surgical opinion first.
@CocaKoala: I don't think any country deals with mental illness particularly well, but I'm often disgusted by what I see here in Australia.
This person is being perfectly pleasant, and seemingly completely open about their possible problems. As they have had to be told by others that they're coming across as aggressive, they clearly haven't been able to recognise it in themselves so no, they couldn't possibly "know" that they've been so aggressive to medical staff that it's been marked on their file. In fact, I think most people in that situation would get defensive and insist they aren't being aggressive, so they're doing better than most.
I deal with aggressive patients all the time who just cannot help it - generally because of dementia etc. or because they are scared and confused. No-one should HAVE to deal with aggression, but I really feel people are in the wrong profession if they cannot tolerate it at all. People generally do not choose to be aggressive (I agree with the anger about dealing with aggressive drunks/drug users etc. but again, you can't possibly understand how their mind is operating and therefore judge that they're "choosing" to be like that), and they deserve medical treatment just as much as anyone else.
The neurosurgeon absolutely, without question, should inform them why they are being refused to be seen - even if it's for "aggression". It's presumably crucial for their treatment (do they need to see another more tolerant neurosurgeon? Should they be seen by a different specialty? Do they need to be reassessed by another GP? Are they fine and don't need anything?).
So you have been aggressive with medical staff?
OP: what about for private referrals?
so yes.
@kaleidoscope: I'm really not sure.
I have been agitated a great deal lately including around medical staff.
How do you know if someone interprets something as aggressive (assuming that they don't tell you)?
Even if you were not aggressive they don't have to see you.
Its like a restaraunt not serving you or a shop not selling you stuff. Its their shop so they serve who they want.
You'd think it is because they don't think you are worth their time. But who knows maybe a medical mistake you are not aware of was made and they just don't want to get involved, or were asked or pressured not to get involved. Nothing surprises me anymore, it's all fairly routine if you look at what happens in your state in just a single month, and that's just what reaches the courts. The medical community is more like a jungle than some kind of orderly system some people imagine it to be. It's why medical law is such a big industry because you can't trust doctors to do the right thing. If you were on a waiting list to be triaged in the first place then you should cut your losses and ask to join a waiting list to be triaged by another specialist. Maybe ask for two different referrals this time just in case one of them refuse to see you too.
I don't understand why you are being negged
I agree with you
and asking for backup referrals is probably good advice, thanks
I can only imagine people without any major ongoing experience with the health care system (or only acute care or cancer care, both of which the system is kick arse at), or doctors/nurses circling wagons which is what they do.
People put medical professionals on pedestals but they're still fallible humans with the same irrational beliefs and habits the rest of us have. Medicine is great with simple mechanical stuff, but anything immune system or neurological is like a black box where myths and religious type thinking rule clinical practice and the cutting edge science takes 20yrs to filter down - as in a speciality moves forward one elderly retirement/death at a time.
And medical science isn't much better, psychology especially is a total basket-case where their study designs for non-pharma treatments like CBT would find homoeopathy "works" because they don't rely on enough objective measures and don't factor in bias in subjective measures. It is like they all know there's a replication crisis, but when the reasons for it are pointed out, heads go in the sand. Even the harder medical science with better methodology is self selected, they get unexpected results they don't publish it, even thought he null finding could be important to stop people wasting time and money on a false lead.
I can't give you enough pluses
You are an interesting guy.
I am having a problem with a psychologist who seems happy to provide his services to my son (for the last 4+ years), yet has my son diagnosed preliminary with a personality disorder & ODD, yet gives excuses why referring my son on to a paaediatric psychiatrist is a waste of time, in his opinion. My opinion is that he enjoys taking the easy mental health care plan monies.
He also won't give me a psychological exam profile of my son for specialist referral purposes, so I have had to subpoena the guy, and I need all of this for family court proceedings.
@Oofy Doofy: that's disgusting
when i have come across doctors who refuse to share records or reports, i have gotten the impression it is because they are trying to make it as difficult as possible for themselves to be sued etc
and why would they be so worried about that if they were actually good at their job?
i don't think it's a coincidence that my worst experiences with them just happens to be the ones who restrict sharing that stuff as much as possible (and from the get go, not after something has gone wrong)
as for refusing to refer, he could be trying to protect you both, but your more nefarious instincts could be right also
just get a referal from someone else - a gp can do it@bargain huntress: The problem with a straight referral, which I have, is based just on an 8 minute appointment with my son. There is no background other than what I could provide to a GP, or specialist when the appointment date arrives. On top of that, there is not a lot of weight applied unless someone like a psychologist who has evaluated my son, gives me this information so I can show a GP and then use that as part of the referral process. From there I can scan and send the referral paper with more information (which psychiatrists usually want, at least in terms of paediatric psychiatry).
It becomes a whole rigmarole to get anything happening.
The problem with a straight referral, which I have, is based just on an 8 minute appointment with my son. There is no background other than what I could provide to a GP, or specialist when the appointment date arrives. On top of that, there is not a lot of weight applied unless someone like a psychologist who has evaluated my son, gives me this information so I can show a GP and then use that as part of the referral process. From there I can scan and send the referral paper with more information (which psychiatrists usually want, at least in terms of paediatric psychiatry). It becomes a whole rigmarole to get anything happening.
I know, but you said you were in the process of getting the records or report from the psychologist;
He also won't give me a psychological exam profile of my son for specialist referral purposes, so I have had to subpoena the guy, and I need all of this for family court proceedings.
So once the subpoena comes through, you just need any referral which sounds like you already have.
But something to consider is if you don't trust this psychologist, are you sure you don't want a
fresh second opinion anyway?Also those waiting times are rediculous for private? How far from where you live are you looking? Find somewhere else.
when i have come across doctors who refuse to share records or reports, i have gotten the impression it is because they are trying to make it as difficult as possible for themselves to be sued etc
No it's because they are sued for anything and everything, even if benign, or something that wasn't even a factor. The legal system will spin anything in the favour of the person suing. Plus, asking a doctor to take multiple days off work, especially someone like a GP who relies on billings to make a living, is ridiculous. That is why most doctors will not make it easy for themselves to be subject to a subpoena.
You think everything is black and white. It isn't.
That is why most doctors will not make it easy for themselves to be subject to a subpoena.
but yet, as i said above, it's not all doctors who do it? and in my anecdotal observation, it has been strongly correlated with doctors who provided poor service to me and others, including right off the bat as a general policy before any indication of a problem.
You think everything is black and white. It isn't.
i do sometimes or often have a tendency for black and white thinking. other times i am better than those around me at seeing nuance for some reason.
could you please point out where you think i am using polarised thinking here?
@bargain huntress: The insinuation that not wanting/willing to be subject to a subpoena is equivalent to poor/malpractice or skill. See:
and why would they be so worried about that if they were actually good at their job?
The truth is, while there are many questionable practitioners, jaded statements like these, especially ones that draw a conclusion based on anecdotes, are not conducive to your argument.
If you feel that many practitioners have wronged you, I can almost guarantee that it is the common factor, and not the medical community on the whole, who is the issue.
@Oofy Doofy: Psychologists can't diagnose and they can't refer, they aren't medical doctors. Ask your GP to refer you to a psychiatrist and they will do a full psychiatric assessment on your son and write a letter back to your GP with their assessment. Ask your psychiatrist to be cc'd in the letter so you receive a copy too. Courts don't consider the opinions of psychologists any more highly than they would a counsellor.
@Jules855: Thanks for this tid bit. The main problem has been the psychologist's refusal to give me any notes and/or a report about my son. He is a child & adolescent psychologist who's been working in the field for 30 years or so. Me going to a paediatric psychiatrist and getting anyone to really believe what I say will be a stretch. All the evidence I have is in daily living and the psychologist. I just want to make sure my son gets all the help he requires.
I already have a referral btw, but the wait in queue is 1.5-2 years currently. This is in the private system.
@Oofy Doofy: If your son is on a Mental Health Care Plan then the psychologist has to write a report back to the GP who made the MHCP after the first 6 sessions and then after 10 are completed (it's a Medicare requirement). Maybe ask your GP for a copy of that report if the psychologist won't help?
@Jules855: Interesting. Well I just hope it's all smooth sailing in terms of getting hold of this information. *The original referring doctor isn't from a GP clinic I have been to with my son.
Thank you
@Oofy Doofy: It is also worth noting that your MHCP can be used with any psychologist, if your current one isn't working out then grab a copy of your plan and take it elsewhere. Same as for your psychiatric referral, the practitioners name on the top doesn't matter, you can take that referral to any psychiatrist if you find one with a shorter list.
@Jules855: The referral is with multiple clinics, unfortunately they are all massively booked for a long long time.
Me going to a paediatric psychiatrist and getting anyone to really believe what I say will be a stretch. All the evidence I have is in daily living and the psychologist.
Are you keeping a daily log / diary / journal?
If not start now. And try to write a history down from memory but keep it seperate from the new daily log.
Video audio and photographic evidence where appropriate is also a good idea.
Me going to a paediatric psychiatrist and getting anyone to really believe what I say will be a stretch.
About your son's symptoms?
What do you think of the personality disorder and ODD diagnoses?
@Scrooge McDuck: My partner, Mother, sisters (4 sisters), friends… you name it, everybody is in agreeance that something is going on with his behaviour (understatement). It's really quite unbelievable. Been showing signs since he was a young boy. Now almost a teenager it's just amplified several times, it's got worse year on year.
@bargain huntress: well the fellow is a clinical psychologist…. which is why I have been getting frustrated with the lack of onward referral and giving me a hard 'No' on giving any form of report. I will try and see if the GP has any real information based upon how the mental health care plan arrangement works, because maybe the psychologist hasn't considered this aspect (for access to psychology/medical information)… maybe it's even protected by privacy laws for my son as he's 12, turning 13 this year.
Any number of reasons. Want to provide some more details on what the specialist said to you? What type of specialist she is?
What type of specialist she is?
Gimme a hundo on Psychiatrist.
You're way off. The Specialist (1994) Sylvester Stallone, Sharon Stone.
A woman entices a bomb expert she's involved with into destroying the mafia that killed her family.
Gimme a hundo on Psychiatrist.
how do i receive my hundred dollars?
First you have to pay the fully refundable $50 clearance fee via Western Union.
Want to provide some more details on what the specialist said to you?
she didn't say anything to me, i didn't get to see her!
What type of specialist she is?
neurosurgeon
may be her books are already full
no secretary was going to make appointment
neurosurgeon
Perhaps she thought it was all in your head.
plate could already be full?
Eating Disorder clinic?
no she is taking patients
How did she triage you without seeing you? What did she say when you asked her?
How did she triage you without seeing you?
that's my question! based on the referral letter?
What did she say when you asked her?
i never got to talk to her!
I'm gonna guess they didn't think they could help you, so didn't want to waste your time?
More info might be helpful.
What do you mean by "triaged"? She saw you once and then didn't want to see you anymore? Or she didn't even see you at all?
Did you see what was written in the referral letter?What do you mean by "triaged"?
that's the word the secretary used
Or she didn't even see you at all?
yes
Did you see what was written in the referral letter?
no
it seems to me with covid everything has been being sent electronically more than ever
i think i will request a copy and see if they will give me one
Sorry to hear about your trouble! Will probably be impossible to know unless you ask the secretary again - keep asking until she gives you a proper reason.
Sometimes the doctor "referral" might be nothing other than looking up a database and picking a specialist that sounds about right.
In my case a few years back I had a bad skin rash and the GP kept fobbing me off so I asked to be referred to a skin specialist. He just looked up a database and picked a skin specialist based on location convenient to me.
I turned up at the appointment and it turns out the specialist was actually a skin cancer specialist so he was quite upset and reluctant to see me but since I was there already he just ended up giving me the same generic advice etc. which was a waste of both our time (and money).
Not saying this is the case but the particular specialist may be specialising in a particular area and your condition is outside his area of expertise.
Maybe they were doing you a favour instead of charging you for something they couldn't deliver properly.
A plethora of reasons, more context needs to be given.
did you haggle over the price?
no
Yes… that's the solution. And I will make a complaint to ACCC when my baker runs out of bread and refuses to make me another one.
Doctors aren't your slave. They go to work and pick and choose how they want to run their business.
I'm assuming this is all private and private rules apply.
If you're concerned, go to a public ED and wait to be reviewed by the trainee to see if it worth pursuing further.
"I'll just type it up on my invisible typewriter".
I'd like to see that…
Good luck with that, Karen.
Make a complaint to medical complaints board
jeese they are negging you hard for some reason
i don't know if it would be a reportable thing seeing as i don't know the reason, it's not like the secretary said 'because you are such and such minority' or 'an &^%&(' or something
also i have never made a complaint, even for some of the horrific experiences i have had
the process is too confusing, and i have always been afraid of reprecussions like other doctors refusing to see me
HOW IRONIC!
Do you really want to see someone who doesn't want to see you?
My wife has had to see the odd specialist over the years and the ones disinterested in her issues don't get a return visit.
Do you really want to see someone who doesn't want to see you?
My wife…
This didn't end the way I expected.
Your interpretation is also valid. :)
Do you really want to see someone who doesn't want to see you?
no. but i'm quite afraid and my gp just promised that this one was really nice. i guess not.
My wife has had to see the odd specialist over the years and the ones disinterested in her issues don't get a return visit.
i don't know how to find one that isn't disinterested. they all are.
my gp just promised that this one was really nice.
Firstly sorry you have a medical condition that needs sorting. Wondering by the above statement from you, there have been incidents between you and Drs/Specialists previously?
If you have "complained" that previous Specialists appeared as not nice, friendly and had a good "bedside" manner, this may have come back to bite you.
Specialists can be very abrupt as they are really busy and time management is their main worry, also as experts, they often tell it like it is and many of us dont like to hear what they say.
I know many friends who seek answers to medical probs in the mental health areas and if the Dr doesn't agree with the patients own opinions "diagnosis and treatment" they degraded the value of the dr and request a new dr time and time again till they get one that agrees with their own opinions.
Stop worrying about the disposition of specialist, stressing over the why they don't want to see you and move on to someone who will see you.
Hope your health improves
I would think either of:
1) The GP wrote a referral to a neurosurgeon because you asked for it but it isnt needed because you self diagnosed and wouldn't accept what they said
2) The GP in the referral didnt support a reason that the neurosurgion thought was worth the referral
3) The referral was to the wrong type of specialist
4) The data on your patient record indicated some issues
5) The neurosurgeon was really busy and hasnt got time to see you
1) The GP wrote a referral to a neurosurgeon because you asked for it but it isnt needed because you self diagnosed and wouldn't accept what they said
Definitely not! I almost begged to NOT be referred. Thus the promises and tales of how great she was supposed to be.
2) The GP in the referral didnt support a reason that the neurosurgion thought was worth the referral
3) The referral was to the wrong type of specialistWhy would my GP do that wrong?
4) The data on your patient record indicated some issues
Such as?
5) The neurosurgeon was really busy and hasnt got time to see you
No the secretary was booking me in until she saw the 'triage'
Disinterested isn't the right word here, disinterested means you are unbiased, you don't have an 'interest' in either outcome
Uninterested means 'not interested'
But having said that, language evolves and disinterested is being misused enough that the meaning will likely broaden and be accepted
Good to know thank you
Do you know where I can learn more about avoiding mistakes like that?
Good question, I don't really know, I wouldn't be too worried about it though, a as long as you can get your apostrophes in the right spot you're doing pretty well. I think you're on the right track, open to feedback which is already a step ahead of a lot of people
exactly if they don't want your business go elsewhere…customers 101
Did you refuse to wear a mask?
no
Usually triage means the urgency with which you are seen. Have you been refused completely or just not within the time frame you are expecting.
completely
Specialist here.
Many many reasons:
1) Your case may be too complex for the service we have. For example, we operate out of a small 3 bed operating suite. I don't have intensive care back up and if anything goes wrong, we are toast and have to call an ambulance.
2) Your case or medical history is too complex to make it worth my while during that timeframe. (i.e. I'm on holiday and I don't want to take patient for that week that may have constant issues I would have to take time away from my kids to sort out). The other day my son complained to me that I didn't spend Christmas with him (working so I moved our celebrations to Boxing Day) and I spent New Years day 14 hours in hospital. If your referral came and I feel that it would affect my kids tennis tournament, I'm sorry, I'm going to go watch my son hit balls way out on that week.
3) Your insurance. Some private insurance plans reimburse us so little that its not worth the effort if you have any complications in combination with the above two points. Some private insurers essentially pay medicare rates and if your surgery is on Friday, I would basically have to spend the whole weekend sorting you out if things happen instead of spending Saturday playing with my son or attending his soccer game. Some times the money is just not worth it.
4) Some procedures I just don't like to do or I haven't done in a long time. I've lost interest in a lot of the things I've trained in and now specialise in doing some very specific surgeries well. If I see your case as something I'm not keen to doing, I won't take the referral. To be honest, I've been lucky. My practice is booked 4 months in advance so I pick the thing that fit my skillset best.
Remember, doctors have lives too…. Just like the plumber doesn't take every job, we have to balance our workload, our family commitments, and our resources.
If you are concerned, go public. They have to take you but waiting list can be long.
I'm going to go watch my son hit balls
But what about my vasectomy? Aren't my balls important?
Do you give the patient a reason for not seeing them?
I'd feel much better if i went to see a specialist for a knee re-construction and they told me sorry, they only do shoulder re-constructions.
Remember, doctors have lives too…. Just like the plumber doesn't take every job, we have to balance our workload, our family commitments, and our resources.
If you are concerned, go public. They have to take you but waiting list can be long.I guess you're saying only private doctors have lives too, because you're giving reasons why not to see a patient whilst saying that doesn't happen in the public system. The 'if you are concerned, go public' comment is something I've heard too often in Australia and it always leaves me with a funny feeling about the medical system here (coming from Western Europe).
Agreed. Though the public/private "fusion" is vaguely working, being from the UK originally, the general attitude on this thread is incredibly depressing to me! The idea that healthcare is transactional and it's perfectly acceptable for doctors to just not want to take the work "like a plumber would" (these aren't pipes - it's a human's life!), or turn down stuff because the amount of money they'd get "just isn't worth the hassle" and they don't want to work on the weekend is never going to sit well with me.
I guess it's a bit different if you grow up only knowing that system?
OMG the number of times you mentioned "spending time with my son"
Mate, you're in the wrong profession. I you want a predictable lifestyle give up your $300K salary and your lamborghini, and get a job in the public service
When you leave at 4.45 pm on a friday afternoon you don't have to think about it again until 9 am on monday
Plenty of time for your son, son.
Umm…Did you ask for an explanation why from said specialist?
how could i - i never saw her?
Usually when they fear for their safety as the patient may have issues of anger etc ? or they don't think you need their particular service