Barriers to Consultation

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Barriers to Consultation

Proper treatment enables physicians and other health care professionals to return quickly to emotional equilibrium with increased productivity and diminished vulnerability both to physical illness and potential impairment. Nonetheless, we may recognize a number of barriers to obtaining medical or mental health consultation. Successfully coping with medical malpractice litigation requires us to remove our personal barriers to get the help we need.

Denial and fears of dependency - Healthcare professionals are very good at recognizing symptoms in others and urging treatment when needed. We may, however, be less aggressive in getting treatment for our own symptoms. We may deny that the chest pain we feel has any relationship to a diagnosable condition. We may hesitate to seek consultation for our persistent cough until we get a chest x-ray that we can interpret. We are accustomed to being in control so that any turning to another for help signals a certain vulnerability. We are often not comfortable becoming a patient. Recognizing these personality features in ourselves, we can then put them into context and work to accept becoming a patient when our individual situation requires it.

It takes time - Consultations take valuable time away from clinical practice. As defendants, we must devote considerable time to consultation with our lawyers and to participating in the legal process so that our temptation is to postpone attention to our personal issues. If we do not seriously prioritize our time commitments, however, we may jeopardize our ability to overcome the symptoms that impair our efficiency and our enjoyment of our work. Getting well is well worth the time we devote to it.

Personal physicians may sometimes be a barrier to our obtaining proper psychiatric consultation and coping with medical malpractice litigation. As physicians, they share a propensity to deny emotional symptoms and think that we are "too strong to have such symptoms." Such propensity often reinforces the temptation to "wait it out" and delay consultation.

Concerns about confidentiality - As members of the medical community, we may be hesitant to consult with close associates or peers due to confidentiality concerns. We should consult with colleagues we trust and about whose ethical standards we are confident.

Concerns about licensure renewal and other credentials - When we apply for a license or credentials, we are generally asked about prior treatment for mental illness, substance abuse, or chronic illnesses that require on-going care. We often fear that we will jeopardize our careers if we answer these questions honestly. In recent years, most licensure bodies have changed from asking questions that focus on diagnosis or treatment to those that focus on questions about occupational impairment. Treatments, including psychotherapy and medication, which we obtain for conditions that do not impair our ability to practice, therefore, need not be reported. Treatment for serious symptomatology requiring hospitalization or loss of time from work should be reported. Applicants should read carefully any licensure or credentialing form and, when necessary, seek appropriate consultation about their response. The state's primary interest is that patients receive safe and competent healthcare. State boards generally appreciate the efforts of its applicants to attend to health issues that necessarily affect their care of patients.