First do no harm.
It is the sacred oath of physicians that reminds them of the power they hold, and enables us to trust them with our health, our lives, our bodies — the Hippocratic Oath. But what if one of the professionals on your health care team crosses the line to abuse or mistreat you?
Medical care can seem abusive
It is the nature of many medical procedures to be painful, seemingly as if they have been designed to hurt or scare you. Joint injections without anesthetic, nerve conduction tests that run electric currents directly into nerves, and let’s talk about the MRI tube with the loud banging sounds. Who came up with these, and why haven’t they figured out a better way of doing them by now?
But medical tests and procedures are not actually mistreatment or abuse. That requires cruelty, impropriety, or violence. And that can happen when you are interacting with a health professional separate from a treatment or device type.
I have a permanent neck injury courtesy of a personal support worker. I receive help with tasks of daily living, including showering. Once, when this person washed my hair, she pushed down hard on my neck and kept pushing. I said nothing. I was frozen, too stunned to feel fear in that moment. Somehow, I knew I could do nothing to stop her and just waited for it to be over. I filed a complaint and she was transferred, then ultimately let go.
As for my neck, it took months of intense pain before it recovered from the injury, and I still live with the aftereffects.
Abuse and mistreatment in health care situations
There are many types of behavior that can be considered abuse or mistreatment. Unnecessary roughness during a physical exam or procedure. Not listening if you ask someone to stop what they’re doing.
“Being told our illness is all in our heads is a form of mistreatment,” said Leslie Rott, a professional patient advocate.
But that’s not all. Although we are usually safe in health care environments, there are times when abuse happens, and it can be sexual abuse and assault. In a national investigation, “The Atlanta Journal-Constitution” (AJC) examined records from every state in the U.S. and found that over 3,000 doctors had been accused of sexual misconduct (and more than 2,400 of those cases “clearly involved patients”). However, this could be merely a fraction of the actual cases — we don’t actually know the extent of the problem. Even when the issue is reported — and as with sexual assault in any context, reporting rates are low — clinics, fellow doctors, and hospitals may not report incidents to state regulatory boards, even though this is a requirement. As well, when such situations are addressed by medical boards, the consequences to the offending doctor are usually kept confidential, according to the findings of the AJC’s investigation.
Power dynamics and fear of not being believed
Reporting abuse or mistreatment can be very difficult. There is a power dynamic in relationships between a patient or client and a medical professional. In certain situations, you can get another doctor, lab technician, or physical therapist, but in others you may be stuck.
In my situation, this individual had engaged in inappropriate behavior before, but not actually hurt me. I had said nothing out of fear of reprisals from her or the other attendants whom I depended on to provide my care. In retrospect, I should have asked that she be removed from my home as an attendant much sooner. But that’s Monday morning quarterbacking. In the situation, I couldn’t.
If you have been mistreated, you also may afraid of not being believed. And with good reason. So often in health care environments, we fight to be believed when we report our symptoms, when we seek help for an invisible illness.
What to do if you have been mistreated or abused
First, know that you are not exaggerating. If you feel that the medical staff acted inappropriately, was unnecessarily rough, or abused you, don’t let anyone dismiss how you feel. Above all, don’t give the individual a second chance to hurt you, if you can at all avoid it.
If the incident took place in a hospital or a clinic associated with a hospital, contact the Patient Advocacy Department or patient services for help.
“The hospital will open an investigation,” Leslie told me. “Depending on the context, the individual may be temporarily suspended during the investigation.”
The result of the investigation would be communicated to you in writing, including information on what to do if you are not satisfied with the result. “If the abuse left marks or was sexual, the person would be referred to the police,” she continued.
You also can complain to state medical boards, although as you can see from the information from AJC’s investigation, this may not lead to a satisfactory conclusion. Leslie added an alternative option of contacting The Joint Commission, the organization that accredits hospitals in the U.S.
This issue is extremely complex and a single article can only touch the surface. If you have been mistreated, abused, or assaulted by a health professional, know that you are not alone. Both in the sense that many more across the nation have experienced something similar, and that other patients or clients of that individual are probably being abused, as well. Please seek help. It may be a challenging process, but you deserve to be heard. And that individual deserves to be sanctioned.
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Lene writes the award-winning blog The Seated View. She’s the author of Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain and 7 Facets: A Meditation on Pain.
Lene Andersen is the Community Leader for HealthCentral’s RA Community. Lene (pronounced Lena) is an award-winning writer, health and disability advocate, and photographer living in Toronto. She’s written several books, including Your Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain, and 7 Facets: A Meditation on Pain, as well as the award-winning blog, The Seated View. Follow Lene on Twitter @TheSeatedView and on Facebook. Watch her story on HealthCentral.