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Angry At My Doctor For Prescribing So Carelessly

Question:

I am so angry about how my antidepressant was prescribed to me. My general practitioner Dr treated these drugs as though they were benign, Looking back, I became unreasonable on 2 meds, prescribed at 2 separate times. I feel this all contributed to fetal demise that occurred. I want to write my Dr. a letter to explain my anger, and to request this Dr to be aware of the significance of these meds and to insist pts see a psychiatrist for correct med evaluation. My question is this, Do you think this will help me with my anger and grief. I’m so angry that I was treated so carelessly. This has affected my life so much.

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  • ‘Anne’ is the pseudonym for the individual who writes this relationship advice column.
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Answer:

I’m sorry to hear about your negative medication experience, and even more so about your miscarriage. Miscarriages are extremely difficult life events to endure. It is clear you are feeling victimized. It is clear you are grieving. Perhaps you have transformed some of that grief into anger as you seek a way of making sense of your loss. At any rate, I feel for you.

I don’t know if writing a letter to your doctor will help you process your grief, but I don’t think it will hurt you to do this. Everyone’s experience of grief is slightly different. The things that will help you get past grief will vary based on your personality and coping style and your expectations of your future potentials. Time will be a necessary ingredient as well. Though you can decide to distract yourself and not show your grief to others, you can’t force yourself to grieve faster; it will take as long as it takes.

Whether writing a letter will help will depend in part on what you hope to accomplish. Do you want an apology? Do you want revenge? Do you just want to be heard? Will it be enough to compose and send such a letter, or will you not be satisfied until you’ve had face to face contrition. These are the sorts of questions I think you should consider as you contemplate composing a letter to your doctor. Some people feel better just knowing that they’ve communicated assertively. Whether their communication results in change is irrelevant; they are content to know that they’ve expressed themselves. Other people need more than simple communication to feel okay again. They need an apology. In extreme cases, they feel the need for revenge. I don’t gather that you fit into that latter case, but if you do, please know that pursuing revenge will not serve any constructive purpose. It will not bring back your pregnancy, and it will not make you feel happy again. It could be quite constructive to share your experience as a means of raising your physician’s awareness, however.

Given the justifiable malpractice litigation concerns that many physicians have (whether guilty or not), it seems to me that anything you say to your doctor that smacks of criticism will be likely to be interpreted defensively. The doctor may consult with an insurance risk management specialist before responding to you. Importantly, though the doctor may want to offer you an apology, or at least to communicate with you regarding your pain and loss, he or she may be counseled against doing so. So it may be hard to know what effect your letter will have on the doctor, should you write and send it.

I think it is important to keep in mind that doctors are in the business of risk management. The medications and techniques they use are dangerous if misused. This is why they must undergo such extensive training and licensing before they can practice. The medications they use might be safe for most people but cause problems in a minority of cases. Open communication and then regular follow ups and patient cooperation are needed for them to be able to correctly appraise and then monitor treatment safety. This goes for general practitioners as well as specialists like psychiatrists. What might have been safe for you prior to your being pregnant might not have been appropriate for you afterwards, for example. Also, what might be appropriate for someone with unipolar (standard) depression, might not be appropriate for someone with bipolar disorder (depression with mania). Often, however, in the early stages of a depressive illness, it is not possible for any doctor to know which illness they are dealing with. All a doctor can do is to make his or her best guess at appropriate treatment and then monitor their patient, adjusting treatment as they go along. It is not reasonable for you or anyone to expect perfection from your doctor. The best you can hope for is that they make medically appropriate decisions at each stage of their contact with you. I say this just to help you keep your anger in perspective. It is not reasonable for you to expect that your doctor would have known about your pregnancy (or possible rare or complicated outcome) unless you told him or her about it. To the extent you did or could not do this, your doctor could not make appropriate adjustments and is not necessarily to blame for the very unfortunate events that have occurred.

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