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"Disrespect during appointment"

About: Karratha Health Campus / Outpatients & Day Treatment

(as a parent/guardian),

I found one of the paediatricians to fill in to be really quite disrespectful. I had 3 children with me, 2 of whom had back-to-back appointments, the dr didn't address or introduce themselves to the children at all.

My younger child would not allow the dr to examine them, and to me, the dr was visibly upset that I was allowing my child bodily autonomy (they had suffered substantial burns to both their feet the day before, to which the dr didn't acknowledge). I allowed my visibly uncomfortable child to sit outside the dr's office watching the television while we moved on to my eldest's appointment.

Right away, the dr began on what I felt was a recurring rant about over-prescribed stimulant medication in the Pilbara and how they had recently read a study about children on stimulant medications having enlarged hearts (failed to mention if the study implied correlation or causation). The dr then ordered a chest x-ray and ECG which thankfully showed nothing abnormal.

The Dr. noted that my child was very underweight. I replied that they have been under the care of the dietician at Population Health, and during that time they have gained over 6kg. Dr stated that if my child didn't gain 2kg in the next month, they wouldn't renew my child's medication script as it would be negligent.

In the next breath, they said as I recalled, my child looked like a classic case of coeliac disease and that they wanted my child to undergo the Gluten Challenge. I told the Dr that we had already undergone a coeliac blood screen before and the results were inconclusive, and could we reconsider the blood test and be referred for a biopsy. I felt the dr stared at me incredulously and shut me down saying the blood test would be mandatory again.

I'm not a dr and I still recognise that if you say a child needs to gain weight, suspect they have a gluten intolerance, and then have them participate in a gluten challenge, that those conditions would, I believe, make it nearly impossible for the child to put on weight (as nutrients cannot be absorbed by a coeliac patient while they consume gluten). My hope was dashed.

The dr also asked if my children behaved differently for my partner than for me, and when I replied maybe, but I think that's because my partner is more focused on punishing unwelcome behaviour, and that I think that style doesn't work with children with executive function disorders. I believe the dr scoffed. To me, it seemed the Dr practically insisted that my partner be present for our next appointment, which we both feel shouldn't be necessary! In my opinion, there is no room for this level of judgement and misogyny in medicine. I explained that we were struggling to get anyone to work with our family and that we had been rejected from CAMHS on more than one occasion, despite my eldest having multiple diagnoses from the Complex ADHD Clinic in Perth.

It seemed the dr was interested in my suggestion of a medication change for my younger child, so they called the authorising agent. When they answered and, as I understand it, said "Hello, how are you? the dr replied with "Well I wish you'd stop overprescribing stimulant medication to the children of the Pilbara, but here we are"! Incredible! The dr discussed the possibility of prescribing my younger child with the same long-acting medication as my older child, but in a lower dosage.

The dr then, I felt, looked at me accusingly and stated that my eldest child "isn't on medication X, they're on Y. They don't even make X in a lower dose". I apologised in confusion, though when I checked my older child's medication at home later, they were definitely on medication X.

At any rate, we agreed to alter the medication my younger child was on, as much as was safely possible since my child wouldn't let the dr anywhere near them.

As we were leaving, the dr then implied, again, that there was no point in attending the follow-up appointment without my partner in attendance! The dr also failed to give us the form for the Gluten Challenge blood work, which I managed to obtain from a GP.

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Responses

Response from Liam Avery, A/Operations Manager, West Pilbara, WA Country Health Service (WACHS) Pilbara 2 months ago
Liam Avery
A/Operations Manager, West Pilbara,
WA Country Health Service (WACHS) Pilbara

Operational Management of the West Pilbara Health Services

Submitted on 9/11/2021 at 10:24 AM
Published on Care Opinion at 10:25 AM


picture of Liam Avery

Dear irregularitymf06,

I am so sorry that you felt disrespected and unheard when attending a Paediatric appointment for your children at the Karratha Health Campus Outpatient Service.

As a parent, you have a good understanding and insight into your child’s complex health needs and I am saddened to hear of the experience you have described; this is not how we want consumers of our health service to be treated and I really appreciate you taking the time to raise these issues and concerns.

I do hope both children have the appropriate medication, prescriptions and referrals in place, which your story seems to indicate, and also that your younger child who suffered the substantial burns is on the mend and feeling more comfortable. To ensure this is the case, and to address the other issues and concerns you have raised, the Senior Medical Officer for the West Pilbara and I would like to speak with you directly to better understand and investigate the matter thoroughly.

My name is Liam Avery and I am the acting Operations Manager West Pilbara. Can I ask you to contact me on 08 9144 7639, or alternatively send me an email Liam.Avery@health.wa.gov.au.

Again, thank you for sharing your experience on Care Opinion. I look forward to hearing from you in the very near future so we can ensure you and your children receive the health care they need in a compassionate, respectful and supportive environment.

Your sincerely,

Liam Avery

A/Operations Manager West Pilbara

WA Country Health Service (WACHS) Pilbara

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