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When an Urgent Care Doctor Failed to Treat Me Because of My Pain Medications

Denise's ankles -- the right one is swollen/enlarged
Denise’s ankles.

It was a Monday morning, and I was visiting urgent care. I wasn’t sure what had happened, but my ankle had ballooned to three times its normal size and there was a visible dent on the side of my foot. I could still walk on it, but it seemed imperative to see a doctor as soon as possible; I opted for urgent care over the emergency room in the hopes of having a shorter wait. I’d showered and my hair was neatly brushed, but I’d dispensed with the makeup that normally makes me look healthier.

It was one of those rare moments when I was seeking medical care for something that was completely unrelated to my numerous chronic illnesses and congenital conditions. However, my issues still cast a long shadow over the consult, as I spent fifteen minutes filling out long lists of conditions, medications, previous surgeries, hospitalizations and allergies on the routine intake form. I’d completed so many medical histories that I’d become very adept at maximizing every inch of space on the page to get all of the information in. When I wrote the word “fibromyalgia” and included my pain medicine – a fairly mild one, which I’ve taken responsibly for nine years at a moderate dose under full supervision from my doctor – on my list of current medications, I thought nothing of it.

The nurse didn’t have any issues with my medical history or meds, and she made her verdict with one glance at my ankle: “Yeah. That really needs to be looked at.” When the doctor entered my exam room, however, he neither looked at me nor introduced himself. Instead, he snapped his gum and started asking rapid-fire questions.

“Why do you take (pain medication)?”

“Because I have fibromyalgia.” “Why do you take (another medication)?”

“Because I have polycystic ovary syndrome (PCOS).”

“Back to the pain medicine. Why do you need that? And you take (another completely unrelated med for asthma) too…”

It wasn’t a consult; it felt like an interrogation.

He did a very cursory examination of my swollen ankle and ignored the information I tried to give him about it.

“We’ll get X-rays,” he shrugged.

“What do you think it could be?” I asked, still trying to be polite.

He shrugged again. “Nothing serious.” He swept out of the room without another word.

In contrast, the X-ray tech was kind and compassionate. It was perhaps this kindness that made me feel safe enough to confide in him after he’d finished taking several images of my ankle.

“I was very uncomfortable with the doctor,” I told him. “I felt that he had a terrible bedside manner and didn’t do a through exam on my ankle. I’d like to see someone else, but if I do need to see him again, I’d like to have a nurse, or you, in the room to help me advocate for myself.” My voice began to shake, and I realized how upset I was. The tech listened quietly.

“Do you want to see that doctor again at all?” he asked.

“No,” I answered.

“Okay,” he told me. “Let me speak to my supervisor.”

He kept his word. The practice manager personally came to see me, apologized for the trouble I’d had, and told me that she’d make sure that I wouldn’t have to deal with the rude doctor again.

The manager kept her word, and a different doctor came into my room. He was very friendly and personable, but his only advice was to “take it easy.” I was not given so much as the standard RICE advice or an ace bandage. He very pointedly told me to take over-the-counter medication for the pain, and storm clouds gathered on his face when I mentioned I had multiple drug allergies.

I suddenly figured out what was going on.

“Look, I’m not here about pain! I’m worried about ripped tendons and permanent damage to my ankle! Please, look at it. It doesn’t look normal, does it?”

“Well, ligament and tendon damage wouldn’t show up on an X-ray…”

“I know that, but something’s obviously wrong with it, so what’s the next step with this?”

The doctor’s entire demeanor changed, and he started discussing possible tendon ruptures. I left the office with a note for my PCP to facilitate an MRI referral.

I think the first provider was just an unprofessional doctor, and perhaps the second would have shrugged me off regardless of who I was. Perhaps neither of them had a background in orthopedics. However, it seemed to me they were both willing to “blow off” a visibly damaged ankle because of their incorrect and ultimately negative judgments about fibromyalgia and my prescribed pain medication. In my state, patient records are electronic and I’d provided them with information about my PCP, so they could have called my doctor or brought up my file at any time and confirmed what I’d told them about my medical history and prescriptions. They hadn’t. I hadn’t asked for any meds or complained about being in a lot of pain. Nonetheless, they’d been willing to send me away without needed treatment or referrals based on their misguided assumptions.

My own doctors and pharmacists know me, and up until now I’ve had good luck receiving respectful, competent treatment from urgent care and emergency room staff. However, I know that chronic pain patients do sometimes encounter difficulties with some healthcare providers.

Is it only a matter of time before I meet another doctor who is “offended” by my medical history and prescribed medications?

Is it going to predispose them to be suspicious of me, regardless of the situation?

And what will happen if I actually have a medical problem that does require strong pain control? Will the doctors help me?

My trip to urgent care has left me with these questions to ponder.

I’m under the care of a competent, informed medical team who has decided on a specific treatment protocol for me. When I seek emergency or urgent care, I don’t need the doctors to question that. I don’t need them to decide I’m somehow less worthy of respect or consideration because I happen to have chronic pain and take prescribed medication to lessen it. I need them to keep to the Hippocratic Oath and help me to the best of their abilities. Period.