“I don’t feel comfortable treating you.”

Image: Clipart family standing near a stethoscope.

Today I had an appointment with a potential family doctor. My midwife and psychiatrist encouraged me to get on as I am pregnant and will also need one for my child’s healthcare. Cool, no problem! I found a doctor accepting new patients at the health clinic just around the corner! What luck!

I was called into his office and he asked me why I wanted a family doctor. I told him that I didn’t have a family doctor and my midwife and psychiatrist were encouraging me to get one due to my pregnancy and the need for my child to have a doctor to go to. He then proceeded to ask me questions about my psychiatrist, where do I see them, why do I see them, what my diagnoses are, if I am or have ever been on psych drugs and if I knew where I could get those health records from over the years. I answered the questions without hesitation. My mental health care is a part of my overall health care history so I assumed he was just starting there and we would get to physical health later, that is really why I was there after all. I told him that I see a psychiatrist through a program at a local hospital to ensure preventive steps are taken against post-partum depression. I said that my most recent diagnoses are major depression and generalized anxiety and that over the years I have been on a variety of drugs and am not on them now. After less than 10 minutes he explained to me that he does not feel comfortable treating my mental health issues and recommended I go to a community health centre in the area (but further away) so I can have a holistic approach to my health care. He explained that it is just him in his practice and anyone he would potentially refer me to in regards to my mental health would possibly cost money.  He also said that there would probably be a wait list but since I’m not due until September I shouldn’t have a problem. He wrote down the name of the community health centre (it’s one I already know) and thanked me for coming in.

I sat there smiling, saying ok, being understanding and it wasn’t until I got to the elevator that it hit me, “Wait…did he just reject me because I’m crazy?”

Image: Health care form with a denied stamp on it.

I do know that doctors, therapists etc. can refuse to treat patients if they feel they are not competent. I respect and understand that. This interaction though just does not sit well with me.

  1. He never asked me about my physical health needs.
  2. He only gave me 10 minutes of his time.
  3. He gave me no choice in having him as my doctor as demonstrated by assuming that I would not like his referrals that require payment and telling me I should have a team of healthcare providers.
  4. He made quick assumptions about the type of patient I would be due to my mental health status.
  5. He dismissed the fact that I have my mental health taken care of and therefore do not need him to do that.
  6. Does this mean that none of his patients have mental health issues? If not then this trend is alarming and if some do then why am I excluded?

The College of Physicians and Surgeons of Ontario says that will not discriminate based on the any of the protected grounds as stated in the Human Rights Code. This includes disability which includes mental illness. The College’s policy on accepting new patients says,

“It is not appropriate for physicians to screen potential patients because it can compromise public trust in the profession, especially at a time when access to care is a concern. Screening may also result in discriminatory actions against potential patients.”

Was I not screened? I think I may have been. That policy also states,

“While physicians should accept or refuse new patients on a first-come, first-served basis, clinical competence[5] and scope of practice[6] are permissible grounds for limiting patient entry into a practice.

Some physicians’ practices are focused on treating certain groups of individuals, such as female or geriatric patients. Where the focus is legitimately based on clinical competence and a clearly defined scope of practice, this would, in most cases, be an acceptable reason for refusing to accept a potential patient. Refusal on this basis likely would not infringe the Human Rights Code.

Decisions to accept or refuse new patients must be made in good faith. Clinical competence and scope of practice must not be used as a means of unfairly refusing patients with complex health care needs or patients who are perceived to be otherwise “difficult.”

Clinical competence and scope of practice must be communicated to all individuals who inquire about becoming new patients. This will help determine if it is appropriate for them to make an appointment.”

Now, GP stands for General Practitioner. General meaning, not something specific. I had no reason to think that I would not be walking out with a GP for myself as I was not told at any point before arriving at my appointment that this doctor did not treat patients with mental health issues.

It is being suggested to me that I file a complaint. I am looking into it.

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25 thoughts on ““I don’t feel comfortable treating you.”

  1. I am fuming angry about this, but I am also tired and it’s late where I am, so I’m just going to say:

    I 110% agree with the suggestion that you file a complaint. You are not seeing him for your mental health issues and therefore they should have no bearing on whether or not he can treat you and/or your child.

  2. He said “holistic approach to my health care.” Sometimes that can be code word for the more quack treatments. Perhaps he’s one of them nuts who does not believe in psychiatrist or psych drugs.
    I’ve certainly run into a few over the years, they think they can cure everything with some New Age bullshit, or are the “Toughen up” crowd. Be a first for a doctor, but they are people too, and I’ve heard some horror stories of awful ignorant doctors.

    • I’ve heard the horror stories too. A friend of mine, her doctor blamed all of her physical health concerns on her depression/anxiety. She eventually found out she has a hormone imbalance and that be fixed/managed. Some doctors clearly use mental ill-health as an excuse for everything. It’s like we don’t actually have physical health lol.

  3. It’s unfortunately quite common in Canada for doctors to do this. I’ve experienced the same I think, but the doctors involved just never contacted me again and basically blackballed me from their office, but I did eventually find a new GP, young doctor fresh to Canada from Ireland, he does however make it clear is knowledge of mental health issues is limited, and this area has limited psychiatrists, but he would do his best. (I don’t currently qualify for a psychiatrist, but when there are only 2 or 3 for a city of 90,000, they have to place limits on who they see.)

    I’d file a complaint, seems the rules are on your side.

    The BC College say’s similar, but it still happens.

    “Like any effective relationship, a patient-physician relationship is built on principles of trust and honest two-way communication, which should be established at the first meeting. While a “meet and greet” meeting is considered acceptable for physicians to get to know a new patient and learn of his/her health concerns and history, it may not be used as a means to select the “easy patients” and screen out those with more difficult health concerns, such as chronic disease. In addition, a physician cannot refuse to accept patients based on human rights issues, such as age, gender, marital status, medical condition, national or ethnic origin, physical or mental disability, political affiliation, race, religion, sexual orientation, or socioeconomic status.”

    But they also say this under the question of is a doctor required to treat a patient

    “A physician is only obliged to treat a patient if:

    the patient has an established relationship with the physician and his/her failure to address an ongoing problem might be harmful (and/or when failure to attend might constitute abandonment); or
    if delay in attending to a patient’s problem might result in serious harm to that patient.”

    So seems there is a lot of wiggle room for doctors here to refuse to treat a patient.

    • I’m now just worried to file the complaint because I don’t want to hear from that doctor and hear his reasons why I shouldn’t be upset. I have the complaint printed so that’s one step.

      I’m sorry you have had similar experiences. GP’s should have a basic knowledge. The College in Ontario says that doctors should be always updating their knowledge. I would like that mental health would be top of the list!

      • You would think, and I think some part of it at least out this way is the large amount of foreign GP’s, some coming from countries where mental health is still very taboo, and others like mine who came from Europe, but they didn’t focus on mental health stuff, so his knowledge is lacking.

        I also think for some doctors, Canada is just a stepping stone to the US, where doctors are a dime a dozen and you would rarely if ever be refused, or find one not accepting patients, but of course on average you pay a few hundred a month possibly, but sometimes I think now, it would be worth it just to have timely access and many times a patient can self refer to a specialist, so if you need more advanced specialist care, you just call the psychiatrist lets say, and make an appointment, but some medical coverage companies still require a PCP (US GP) to refer,

        I get what your saying on the complaint.

      • I believe this doctor was either born in Canada or came here very young. He’s probably only a handful of years older than I am. He got his medical degree in Canada. i have heard that Canadian medical doctors are only required to have 1 class on mental health. Despite the research that shows mental and physical health are directly linked they are always separated and then we’re left with GP’s that have no idea what to do.

        I’m still of the mindset of being fine with not having to pay even if it means waiting. I don’t know anything else though lol

      • I would not mind the waits if they were reasonable but some of the recent waits have been horrendously long, 9-12 months, which is where I have the issue, and of course the poor mental health services the public system provides here at least, no wait because the system simply doesn’t offer what many need, basically boils down to medication, if you can be medicated the system will provide it, need anything else, your more or less on your own.

        My wife is bipolar and can’t even get a psychiatrist where we are because there are so few they cannot take anymore patients.

        There just doesn’t seem to be any real plans in much of Canada to reform and improve healthcare and at least here its only gotten worse despite more money being spent, where the money goes is anyone’s guess.

        I would not be surprised if GPs here only receive very minimal mental health training, and seems par for the course in many countries and mental health, mental health is still the step child of the medical system throughout the world.

      • A few years ago the national mental health plan came out and then nothing really seemed to change. In Toronto, a lot of new things are popping up for youth and adults and seniors are still waiting for their turn. I have a psychiatrist and still waiting on a therapist. Having both is a part of the program I’m in but I’ve been without a therapist in that program for a month and a half. The counsellor is supposed to help me work through some stuff and come up with actual strategies to be an effective person and parent. Baby is due end of September…it’s basically August…so I don’t know if I’ll even have a counsellor before the baby is here lol I have a drug pusher though…I actually cancelled an appointment because I couldn’t deal with seeing her. She just scares me every time.

      • Youth have more options out this way, there is actually quite a lot of options for the under 25 group, oldies like me have far less options.

        The therapist I see from time to time when we have the money does long term DBT for youth services and is well versed in DBT, just she is also pricey so I maybe see her once every 3 months on average, so I can’t say its super helpful, but in BC services from therapists, counselors, psychologists ect are not covered by medical services. Psychiatrists are but they are not option for me and few will even consider even seeing someone with borderline since its not something they can treat with medication and that is all psychiatrists do for the most part, I really get no benefit out of a psychiatrist appointment of 10 minutes every 3 months.

        Wife has extended medical but they will only cover like 2 weeks worth of DBT group/individual before the yearly maximum is hit, so its of no real use.

        I’ve attempted to get an exception for MSP to cover it, but they won’t, nor will disability so for now I am just pure out of luck.

        Now if I could afford to live in Vancouver, I would have options but rents there are more then our entire months income….lol

        Hope you can get your therapist lined up before the baby comes, but time seems to indicate the baby may come first.

      • I should add BC is divided into health regions and well for whatever reason unlike physical medical conditions, its near impossible to access mental health services in another health region, community based an all, but unfortunantly the smaller city’s that are not Vancouver have limited resources, and DBT, borderline and other disorders are too high maintenance for many of the local mental health offices.

      • I have and did almost sign up, but its just a money issue, I am not working at the moment, and our disability runs out soon (once we make 18k, they stop disability payments) and well rent alone eats up almost 50% of my wifes income alone, and we live in the cheapest city in the area in a cheap apartment for this areas standards, so even 90 or 100 a month is too much at the moment.

        Maybe when disability resets in February, not easy living in BC these days, no affordable housing unless you go to the middle of nowhere…

      • Life is just getting too expensive these days. Wouldn’t be so bad if income went up slightly more then the cost of everything else but it doesn’t, crazy to think income now is the same as I made in 2006, but back then I paid 450 in rent vs almost 1,000 now.

      • I still remember when gas was 60 cents lol Toronto is having such a housing crisis because homes and rentals are so expensive. I will probably move out of the city within the next few years. I have had to make many cuts to mental health care because I need to do other things. I’m going to try and hang on to my online counsellor for as long as possible (it’s about $66 bi weekly but I’m only getting paid monthly now and it’s not predictable).

      • Sounds like your area is about the same as here, we are at what you can call the city of last resort…lol… Its the last reasonably sized city still within commute distance of Vancouver, but its become less affordable now as well. In the last year rentals on average have gone up 400-500 a month, what used to rent for 600 now rents for nearly 1,000. Vancouver is of course out of this world now, rental and owning, doesn’t help they really don’t build rental units anymore so the rental market relies heavily on people renting out basement suites, and condos where permitted.

        Its crazy insane, in BC now unless you move to the middle of nowhere or up north, there just is nothing left that is affordable.

        I think when I first came to Canada, gas was 64 centsliter, now its around 1.05, but not unusual to see 1.40 to 1.45 at times, but this year we have been lucky and has stayed fairly low, 1.20 or so has been the highest this year so far.

        Good luck with your online counseling!

      • I remember when gas went to 98 or 99 cents and people were freaking out because it meant the oil companies weren’t doing well and what would that mean for the economy. I was blown away by the concern because we were getting closer to affordable gas again!

        I wish we could actually live our lives. I feel like everyone is simply surviving. It’s upsetting. I hope it changes over the next handful of years. I know I don’t want my child going through what we’re going through.

        Thank you for your comments 🙂

      • Our gas would be cheaper than it is, but we have a carbon tax on gas, so we tend to not see the lower prices other regions see, but we have cheap electricity, one of the few things in BC that is cheap…lol

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